Whether your practice is already established or you’re just starting out, doing your own medical billing might seem appealing. It can’t be that difficult, you ponder, and it will save money — that’s a good thing, right?? Well ……… let’s delve a little deeper to see what medical billing entails, and if processing your own billing really does benefit your practice.
Initially third-party billing may seem fairly simple, but it’s not. Medical billing can be complex. Filling out the claim form and submitting it to the insurance company is the easy part. There is a lot that may need your time and attention after that.
There are many steps to the billing process, so it’s possible for insurance reimbursement to “fall through the cracks” at any point. If you’re not paying close attention, it could easily be overlooked. Being diligent and following up is essential – not only to getting the claim processed but also to your bottom line.
Let’s look at what it takes to do third-party medical billing well:
◆ ARE YOU ORGANIZED?
You will need to gather a great deal of information to do the billing: patient information, insurance company information, electronic payer ID#, authorization # (if needed), diagnosis code, dates of service, procedure codes, etc. You’ll also need to stay on top of any changes to a patient’s insurance coverage OR if the patient has a new/different insurance policy.
◆ ARE YOU DISCIPLINED?
Will you be able to do your billing in a timely manner, on a regular basis, to keep your cash flow flowing – as well as complying with the timely filing rule?
◆ ARE YOU WILLING TO LEARN ABOUT MEDICAL BILLING?
Will you first need to spend time learning how to do medical billing, along with all the ins and outs?
◆ DO YOU HAVE THE TIME?
Your time is limited. Will you have enough time, on an on-going basis, to devote to managing and following-up on all aspects of the billing process, as follows:
➔ Will you have time to log insurance payments and patient payments to the appropriate accounts to keep things accurate?
➔ Will you have time to review all of your EOBs (electronic and paper) to determine if the claim processed properly, and if not, contact the insurance company for the claim to be re-submitted/ re-processed?
➔ Will you have time to follow-up with an insurance company when payment for a claim is denied to determine if the denial is accurate?
➔ Will you have time to stay on top of tracking authorizations in a timely manner so you’ll know when filing a new authorization request is needed?
➔ Will you have time to track patient accounts/accounts receivables and send bills to your patients for deductibles, copays or co- insurance?
◆ WHAT ABOUT BEING ABLE TO ACCOMMODATE EVERYTHING ELSE PERTAINING TO YOUR PRACTICE?
✓ Cultivating referral sources
✓ Developing Financial Policies and Procedures
✓ Clinical Documentation
✓”In-between” phone calls from patients
✓ Marketing (including social media, blogging, etc.)
✓ Scheduling
✓ Credentialing/Re-credentialing
✓ Etc.
Other than the clinical therapy service you provide, processing medical billing efficiently is top priority for operating your practice and keeping it financially sound. Investing in resources that will benefit the daily operations of your practice is an important choice. Choose wisely when deciding who the right billing administrator is for your practice.
~ Nadene Vigoda ~
DOLLARS & SEN$E
Medical Billing & Bookkeeping
….. helping you manage your day-to-day finances …..