Medical Billing Company Effect on Healthcare Business Growth

How does a Medical Billing Company Impact Towards Healthcare Business Growth?

 

Medical billing and coding companies’ services are essential to robust growth in RCM – revenue cycle management in healthcare business settings. There are many factors a Medical Billing Company Effect on healthcare business growth, improved collections, and KPI indicators. This can be more effective and result-oriented when a top-rated medical billing services company is chosen. Generally, performing the tasks of insurance credentialing, medical billing and coding, is critical for ensuring compliance. Still, they are also essential for reducing the number of claims denied or rejected, which affects the revenue cycle management of healthcare business in the United States very badly. In today’s value-based healthcare environment, hospitals and other healthcare institutions are measured based on the quality of care provided. Even the slightest deviation in clinical documentation at the healthcare practice level can leave considerable gaps in the revenue stream and the delivery of quality care to the patients. This is because even the most minor deviation in documentation is based on the patient’s medical history that reflects on the claim. Clinical Documentation Improvement (CDI) will remain of paramount significance so long as your medical billing company continues to serve as the primary resource for small size medical practices, medical groups, and hospitals.

Claims Processing and Patient Billing Workflow

The efficiency of the people who manage the medical coding and billing processes significantly impacts the total cash flow that a medical practice generates. The provision of high-quality care to patients is the primary focus of all professionals working in the healthcare industry to ensure that the paperwork is completed in compliance with all regulatory requirements. On the other hand, increases in proportion to the number of patients generate more stress on the procedure being adopted to follow for the stability and continuity of healthy RCM workflow. However, as long as this paperwork perform accurately, you have no reason to be concerned about it. Effective medical billing and coding benefit patients, healthcare providers, and RCM solutions providers like medical billing companies. Having the right medical billing company standing by your side helps healthcare business owners and decision-makers responsible for delivering quality care. If you have a medical practice that has a system in place to identify the patient responsibilities accurately and automate the workflow to collect due balances from patients for finalized insurance claims, you can guarantee a consistent cash flow and revenue growth in healthcare practice, and that will increases the client satisfaction level significantly.

 

Medical Billing and RCM Key Performance Indicators for Healthcare RCM

Your ability to effectively identify and implement the KPIs (key performance indicators) is essential to determine your practice performance in achieving your goals. Medical billing companies generally have the KPIs being monitored by their employees to ensure lowering the number of claims that are denied and maintaining a healthy revenue cycle. When assessing key performance indicators (KPIs) in a value-based approach to healthcare, the efficiency of the medical billing companies matters because correct coding and documenting the process on the clinical side will only get benefits when expert medical billers are handling it. Two factors primarily determine these:

1.   Productivity in Coding:

The number of hours spent coding can be calculated by taking the entire records count and dividing that by hours spent by the clinical staff, such as Medical Directors or Directors of Nursing. What determines how efficient a process is is how little time it takes to do the most difficult tasks. Inpatient coding records should be completed at a rate of 24 per eight-hour paid workday as an example of an acceptable requirement for effective productivity in coding. Despite this, this metric will need to update due to additional coding tasks. The complexity of the management structure, case mixing, and other factors. The numbers can be improved if you have an EHR with a great SOAP Notes workflow designed based on your practice specialty and other needs.

2.   Accuracy in Coding: 

Since the healthcare organization is responsible for assigning coding levels, a policy document that evaluates how accurately the levels are coded is necessary. The official manuals and online coding tools can improve coding efficiency and serve as benchmarks. When using a Certified EHR, you will get the coding validation tool to ensure your procedure and diagnosis codes are compatible. Such EHR Systems also enable checking drug-to-drug and drug-to-disease allergies to ensure that no wrong medication is prescribed to the patient.

How Does Efficient Medical Billing and Coding Contribute to the Positive Aspects of Your Practice?

The following is a list of benefits that can be attributed to the preciseness and efficiency of the billing and coding process:

1. Having an Effective Medical Billing System reduces the number of Demands Placed On Physician And Their Support Staff :

The majority of those working in healthcare continuously undergo time sensitivity. Patient care consumes most of the staff’s available time during the day. If workers also have to make the claims ready for submission, check on rejections, follow up with insurance and perform payment posting tasks, their workload may become unmanageable. It is only a matter of time before a claim is filed, either with incorrect coding or with the correct one. Still, it takes more than time, such as hands-on experience, familiarization with insurance rules, and understanding the complex medical billing process, to get the claims finalized and paid by the insurance company. If industry experts do not handle the RCM process, this leads to denials, leading to a reduction in revenue. If you have an efficient medical billing company on board and working efficiently, there will be no delays in payment, and your employees will be free to concentrate more on the patients. The problems caused by unpaid claims and bad debts will no longer be an issue by having a top rated medical billing company working tirelessly for your success.

2. Avoidance of errors in medical billing that might have unfavorable repercussions in legal matters

When assigning a medical code to a particular treatment a provider supplies, a biller needs to pay careful attention to the particulars and look for the codes that most accurately describe the service delivered. When assigning a code to a medical operation, even the tiniest mistake might cause a delay in payment or even result in the denial of claims. Sometimes even such mistakes would result in sending clinical documents to the insurance companies to prove the necessity of the services delivered and filing a claim re-consideration, claim re-processing, or even filing appeals. Such billing and coding mistakes could potentially consider a criminal offense, and in some cases, insurance payers start investigating by having an audit of the healthcare practice. When deciding on a healthcare business opening, always choose a medical billing company that is efficient and accurate in case you don’t have an expert medical billing team to work for you in-house. You not only reduce the risk of legal ramifications but also eliminate the risk of any delays or denials instead of receiving compensation.

3. Assists in the Establishment of a Productive Procedure, Which Facilitates the Prompt Verification of Patients’ Eligibility:

An efficient workflow for the medical billing system will ensure that the patient’s eligibility information is checked well in advance. This will ensure that the claims are not denied, and that appropriate reimbursement will be received. This requires in-depth knowledge of insurance integration and usage of eligibility and coverage benefits verification. In the old days, the employees did the benefits verification manually. Still, nowadays, you can have medical billing software to check the patient’s eligibility and benefits verification automatically and instantly. Medical Billing Companies have the right tools in place that helps healthcare businesses to go easy on scheduling appointments, designing an easy intake process to collect patients’ data to ensure that biller has the most accurate information to bill the claims and get them paid in the first attempt.  To be efficient, you can be confident that you will top rated medical billing company on board, and you can utilize experienced medical billers to minimize the number of claim rejections whenever you submit them and get the required reimbursement more quickly.

 

4. Timely Payment of Claims and a Steady Flow of Cash to the Medical Practice:

When starting a medical practice, constant cash flow is vital to keep the business alive, and medical billing services for small practices can help you with that. The primary requirement for continuing medical practice is the provision of consistent financial resources to the organization. This is a possibility only if there are a few claims that deny. Claims that are filed for reimbursement must be accurate and comprehensive by having an efficient coding and billing procedure in place that ensures that these claims are being sent through a clearing house, get on file with insurance companies, get processed, finalized, and check is received in the healthcare provider’s bank account. This not only helps to ensure that claims pay in a timely and regular manner, but it also contributes to the overall health of the practice.

 

Need Help with Medical Billing Services?

If you are looking for a Healthcare RCM Solution that can help you improve your collections, and revenue, contact iCareBilling today by scheduling a call back and we will get back to you shortly.