Medical Billing - Improving Cash Flow: Start with Denials & Missing Information…

Often, a practice CAN BE "on the fence" in their decision to hire you as their Medical Billing Firm. If that is the case, ask them to "test" your services by giving you the "junk" or denied claims. I own and operate a successful Medical Billing company and YES; I too occasionally have to "prove" my services. It's not often, but it does come up. When their hesitation is clear, I offer to take on their most difficult claims and/or insurance carrier fact-finding work, which takes their staff member too much time. Now, of course I ask for a per-hour fee and a higher percentage for working these denied or old claims. They are a lot more work than the fresh ones and often need to go through an appeals process. This process has earned me SEVERAL accounts. After reaping the rewards of my diligent work on these old claims (a.k.a. income), they hire me immediately and WITHOUT hesitation. For more information and true guidance as a medical biller, visit www.MedicalBillingFoundation.com. This is the ONLY institution available that offers this level of counseling, instruction, ideas and support concerning these types of scenarios that you, as a biller, can undertake to ultimately earn ALL business opportunities that are offered up to you. Try to NEVER walk away. Below is information about medical bills "missing' crucial information for processing...

It might seem impossible that a patient would undergo hip-replacement surgery without anesthesia, but it’s been known to happen. Likewise, there have been cases of surgery to implant a pacemaker without the actual pacemaker. Or at least that’s the impression you might have upon noticing such items glaringly missing on the bills sent by the healthcare provider!
The situation is almost humorous, if it were not so serious. Doctors across the country lose millions of dollars every year due to mismanagement of the billing process. The reasons range from inaccurate charging, such as undercharging for a service or procedure or missing a charge altogether, to sending out claims that are for various reasons deemed inaccurate by the insurance carrier and therefore denied.
These service and item omissions and claims denials generally stem from an unhealthy mixture of unwieldy process, improperly trained employees, and inadequate technology. Fixing the problem, therefore, means determining the underlying causes and then directing resources toward those areas.
Whether the solution involves instituting new procedures and technology, or outsourcing the billing altogether, the benefit should be obvious.
Accurate charge capture and claims denial management processes mean not only improving cash flow, but also protects revenue that the provider is entitled to – and that adds up to a healthier bottom line.
No matter the size of the organization, billing inconsistencies affect all healthcare facilities to some degree – even those that are on top of the problem.
On average, providers lose 5 percent of gross revenues, and that can translate into millions of dollars for a single organization – yes, even the smaller practices over time.
With reams of regulatory rules, disparate software systems, and frequently high employee turnover, opportunities for mistakes to occur in the billing process are many.
At the worst point in the health system’s billing problems, the actual denied claims were measured in yards and feet and inches, depending on the size of the practice.
If you are hesitant in getting help from an outsourced solution on a full time basis, reach out for help on a project-to-project basis. A good Medical Billing Company should leap at the oportunity.
-HFMA, Mar. ‘07