Medical billing is a crucial health care service that supports physicians by submitting and collecting the payments from insurance companies and patients. One needs to be an expert to ensure that the bills are collected fully and in a timely fashion. It is quite common for over 20% of a practice's potential revenue to remain unclaimed because of improper coding and weak collection strategies.
Outsourcing medical billing is growing in popularity as an approach for addressing this tremendous loss of practice income. The range of outsourcing options runs from extremely large organizations to individual freelancers who work from home to provide medical billing services.
In thinking through the billing options available, it is crucial to understand that medical billing is complicated and requires deep expertise and broad experience. When a specialty is involved, such as surgical billing, the requirements for success become even harder to achieve. Success requires that the medical billing company have a team that is well versed with the complex rules utilized by insurance companies to adjudicate surgical medical claims.
The choice of an experience billing provider has become all the more important for surgeons as they watch their cost rocket upwards. With their margins shrinking they must be confident that their surgical billing service is collecting every dollar the surgeon is owed. Selecting the proper medical billing service is made all the more difficult by the fact that many companies claiming to be experts in billing for surgeons actually do not do the billing themselves, but outsource the work to other vendors that are based in India or work from their homes.
A key battle ground in the struggle to collect all of the money due a surgeon is appealing denied claims and answering extremely specific and technical questions about procedures and diagnoses. Success In this arena requires significant experience, the kind that is only gained from serving many surgeons for many years.
A typical sort-coming with medical billing services that do not specialize in surgery billing is the inability to properly track and pursue insurance underpayments. These underpayments cost most surgeons about 10% of their potential income. If a medical billing company does not understand the mult-procedure rules and have a system that can track underpayments (and does not flag every payment on a second procedure as underpaid), they will find it difficult to capture this lost revenue is a systematic manner.
These billing complications extend to the patient collections arena as well. The patient collection process for specialists like surgeons is more complicated because of the large patient balances often owed, the complexity of the procedures/EOBs that must be explained to patients that do not understand their bills and the older population surgeons often serve. A medical billing service with expertise in billing for surgeons knows how to deal with these situations. Billing services without such experience will increase the risk of both lower patient collections and upset patients confused about their bill.
The bottom-line is that is not worth the risk for a surgeon to use a billing company that is not as focused as he or she is on surgery. Just as a patient should not go to a family doctor for surgery, a surgeon should not go to a generalist billing company for medical billing.
Copyright 2008 by Carl Mays II
Outsourcing medical billing is growing in popularity as an approach for addressing this tremendous loss of practice income. The range of outsourcing options runs from extremely large organizations to individual freelancers who work from home to provide medical billing services.
In thinking through the billing options available, it is crucial to understand that medical billing is complicated and requires deep expertise and broad experience. When a specialty is involved, such as surgical billing, the requirements for success become even harder to achieve. Success requires that the medical billing company have a team that is well versed with the complex rules utilized by insurance companies to adjudicate surgical medical claims.
The choice of an experience billing provider has become all the more important for surgeons as they watch their cost rocket upwards. With their margins shrinking they must be confident that their surgical billing service is collecting every dollar the surgeon is owed. Selecting the proper medical billing service is made all the more difficult by the fact that many companies claiming to be experts in billing for surgeons actually do not do the billing themselves, but outsource the work to other vendors that are based in India or work from their homes.
A key battle ground in the struggle to collect all of the money due a surgeon is appealing denied claims and answering extremely specific and technical questions about procedures and diagnoses. Success In this arena requires significant experience, the kind that is only gained from serving many surgeons for many years.
A typical sort-coming with medical billing services that do not specialize in surgery billing is the inability to properly track and pursue insurance underpayments. These underpayments cost most surgeons about 10% of their potential income. If a medical billing company does not understand the mult-procedure rules and have a system that can track underpayments (and does not flag every payment on a second procedure as underpaid), they will find it difficult to capture this lost revenue is a systematic manner.
These billing complications extend to the patient collections arena as well. The patient collection process for specialists like surgeons is more complicated because of the large patient balances often owed, the complexity of the procedures/EOBs that must be explained to patients that do not understand their bills and the older population surgeons often serve. A medical billing service with expertise in billing for surgeons knows how to deal with these situations. Billing services without such experience will increase the risk of both lower patient collections and upset patients confused about their bill.
The bottom-line is that is not worth the risk for a surgeon to use a billing company that is not as focused as he or she is on surgery. Just as a patient should not go to a family doctor for surgery, a surgeon should not go to a generalist billing company for medical billing.
Copyright 2008 by Carl Mays II
About the Author:
Carl is affiliated with a medical billing company that specializes in billing for surgeons. To learn more about how a focused billing company can help your practice please visit Surgical Billing Partners website of their Surgical Billing Blog. If you have specific billing questions please feel free to contact Carl through either of the two sites mentioned above.
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