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May 13, 2022 by smallcrowd 0 Comments

In-Network vs Out-of-Network Insurance 

Healthcare providers venturing out into private practice often don’t know how to deal with the process of getting paid for services. They’re understandably unfamiliar and can feel a sense of confusion surrounding billing and insurance. Healthcare providers are typically not taught about healthcare billing in their training, so this is an area that needs to be addressed in order to succeed in their offices. 

Creating a revenue cycle for your practice can be a difficult process, but with some advance planning and a bit of research, you will feel much more confident about the entire process.

First things first, you need to understand the difference between in-network and out-of-network insurance companies, how they operate, and why it’s integral to have insurance credentials. Without insurance credentials, you won’t be paid for the medical services you provide to your patients. 

What is the Difference Between In-Network and Out-of-Network Insurances?

Health insurance is an important topic for many people. However, it can be tricky to understand the difference between in-network and out-of-network coverage. It’s easier to comprehend than you think. When patients find you, you’ll either be in-network or out-of-network. 

In-network coverage is when a person goes to the healthcare provider that they have chosen to be in their network. This means that they will not have to pay any more out-of-pocket expenses for the medical care that they receive. As a provider, you want to be in-network with as many insurance companies as possible. Patients prefer to go to providers that are in-network. 

Out-of-network coverage is when a person goes to a healthcare provider outside of their network. This means that they will have to pay more out-of-pocket expenses for the medical care that they receive. Patients are less likely to go to providers that are out-of-network. 

Why Is Insurance Credentialing Important?

The credentialing process for insurance is an important process for a number of different reasons. For starters, it ensures that the person applying for a license is qualified to do so. 

This can reduce instances in which unqualified individuals represent themselves as licensed professionals, which in turn can provide consumers with false information and potentially cause them to make bad decisions. 

You should consider what insurance companies you would like to contract with. Some major insurance companies are Blue Cross Blue Shield (BCBS), Medicare/Medicaid, United Healthcare, Cigna, and many more. You will have to fill out an application for each insurance company that you want to be in-network with. 

These applications can easily take around 2-6 hours to complete. This is where a medical billing company can provide some assistance. Hiring a medical billing company can help you with insurance credentialing applications and speed up the complicated process. 

Get Professional Streamlined Medical Credentialing 

Credentialing with insurance is a lengthy, time-consuming process. If you’re looking for professional streamlined insurance credentialing, you’ve come to the right place. Here at AMS Solutions, we take medical and insurance credentialing very seriously. 

AMS Solutions is a leading provider of credentialing services in the insurance industry. No matter what insurances you are looking at, we’ll make sure you get contracted with them. 

Let us take care of all of your medical credentialing needs with quickness and efficiency. We know you don’t have the time required for proper medical credentialing, which is why we’re here to save you time and money. 

Send us a quick message here, or feel free to call us anytime at 214-522-0210. We’re so excited to hear how we can help you and learn more about your private practice!

We also offer free practice audits for your convenience. 

May 13, 2022 by smallcrowd 0 Comments

How To Combat Recoupment Requests

Getting a recoupment request can be scary and worrisome. Recoupment is a provision in most health insurance policies that allows the insurer to request a repayment of some or all of the cost of care after it has been provided. Most insurance companies have this provision, but it is not often used. 

Companies may also request repayment for certain services when they do not agree with the treatment they provided. There could be disagreement over in-patient and outpatient treatment, as well as disagreement over the use of imaging services and lab tests that were provided. 

If you need help with combatting a recoupment request, you may want to seriously consider getting a medical biller to help with the appeal process. 

What Exactly Is Recoupment?

As aforementioned, recoupment is a term used in the insurance industry to describe the process of recovering money from a third party.

The term is most commonly used in reference to health insurance, but can also be applied to other types of insurance policies. In the insurance industry, recoupment is a process wherein an insurer recovers money from a third party. 

This process can come as a result of either legal action or voluntary payment. Recoupment is often used to cover losses that occurred due to an accident between two parties. Hiring a medical billing company can help you fight any recoupment request. 

Common Reasons for Recoupment Requests

The recoupment process starts with a written request for repayment. This will be accompanied by a phone call or email to alert the medical insurance provider that there was an error. 

Just about every insurance company will give you up to 30-60 days to take action once the initial request has been sent and delivered. There are many reasons why a recoupment request can occur. 

The most common reasons for recoupment requests are:

  • Duplicate payments for the same service code/date
  • A duplicate claim was submitted in error
  • Payment sent to an incorrect healthcare provider
  • Payment for a service that happened after the patient’s insurance plan expired
  • Payment made for a supply or service that was not covered in the patient’s insurance plan
  • The insurance claim was paid for an ineligible beneficiary 
  • The patient’s total deductible was miscalculated

How To Fight A Recoupment Request 

As a healthcare provider, there are ways you can fight a recoupment request if you believe it’s not valid. One of the first steps you need to take is to ask for all relevant documentation from the insurance company relating to the patient’s claim and the recoupment request. This ensures that you have followed guidelines by verifying the payment against established contract guidelines.

If you have received a contested recoupment request, it’s important to get in touch with your state insurance commissioner as soon as possible. The state insurance commissioner is the best person to ask about the rules and regulations for this type of situation.

There are some states with firm timelines for recovering returns which can affect how the process goes if a breach of contract occurs later on. When analyzing these documents, be sure to look for those areas where the breach happened. It’s crucial to assess which party should be responsible for the compensation and know how much of the agreement needs to be fulfilled financially.

Avoiding Recoupment Requests

The practice of recoupment is typically done by collecting money from the patient or their family. There are many ways to avoid this situation, but one of the most important things to do is to hire a medical billing company for your office. They will not only handle all the billing, but they will also make sure that you don’t get any recoupment requests in the future.

This is where AMS Solutions comes in. The best medical billing company in Texas is AMS Solutions. We have over 20 years of medical billing experience and know exactly how to maximize your profits as a healthcare provider.  

Get a free practice audit today! 

You can also call us at 214-522-0210 or email us at

May 13, 2022 by smallcrowd 0 Comments

The Most Common Medical Billing Mistakes

The medical billing process is typically long and complicated. It can be difficult to keep track of all the details and make sure that you are following the right steps. There are many mistakes that can happen during this process, which can lead to a patient’s account being sent to collections.

In this article, we will go over the most common medical billing mistakes and how you can avoid them so that your patients don’t end up with a bad credit score or a debt collector knocking on their door.

What Are Common Medical Billing Mistakes?

Medical billing mistakes can have disastrous consequences. Whether the mistake is with your patient’s personal data or the insurance code, a medical billing mistake can result in some very harsh consequences.

The 4 most common medical billing mistakes are:

  1. Unbundling

It can sometimes be hard to tell when certain services should be billed together and other times it is not, often resulting in a higher total claim. Avoid this by always bundling services done at the same appointment.

  1. Incorrect Billing

Incorrect billing is when a medical practice charges a patient for incorrect services or for services that they never received. Incorrect billing can also happen when a member of the staff inputs incorrect patient or provider information. 

  1. Duplicate Billing

Duplicate bills often happen when someone accidentally sends the same bill twice. It could be that they failed to notice they already sent the claim and sent another, or it might mean there are duplicate procedures in a patient’s records.

  1. Upcoding and Undercoding

If you don’t include a medical billing code for less expensive procedures, it can happen for a few different reasons. What matters most is that under coding always appears suspicious and your office can get into trouble – same with upcoding. 

Many medical facilities are faking the severity of procedures they offer in order to receive higher payments. This is the definition of upcoding and it’s a form of fraud that can lead to significant financial losses.

Hiring a medical billing company can prevent many of these common medical billing errors. Medical billing companies use billing software that effectively minimizes the chances of medical billing mistakes. These billing mistakes can ultimately have a negative effect on your office and your patients. 

How Billing Mistakes Negatively Impact Your Office

If you think making medical billing mistakes won’t impact your office, think again. This is what can happen when you consistently make billing mistakes:

  • Hiring Extra Staff = Extra Expenses 

When a mistake is made in the medical billing process for your office, you’ll have to hire additional staff in order to fix the mistakes and current workload. This means extra expenses that wouldn’t have needed to be spent if the mistakes were avoided in the first place. 

  • Delayed Payments 

The delayed billing caused by your remittance process makes it more difficult to project cash flow, as you can’t reliably know when revenue and expenses are expected to come in. This means that while the delays may be reasonable, this only complicates things when you need to explain why your rent is late or tell the insurance company that you are behind in processing payments. 

  • Stressed and Confused Patients 

Explaining medical billing to a patient can be tricky, especially when it comes to medical billing errors. Someone who is sick or unable to work (because of an injury) may be worried about having to pay for their doctor’s visits and treatment. An unhappy patient is more likely to share their grief with family and friends. Negative word of mouth is the last thing you want for your office. 

  • Unsatisfactory Revenue Cycle Management

The revenue cycle typically starts when an appointment is booked and concludes with the bill being paid in full. A short cycle is best while long cycles may indicate problems in your office’s revenue cycle. 

All of these mistakes can be avoided when you take the proper precautions and you have a professional medical billing company working for your office. 

How to Prevent Medical Billing Mistakes with Our Medical Billing Company 

Medical billing is a tedious process for medical providers, but with the help of AMS Solutions, it doesn’t have to be. Our comprehensive medical billing company provides a wide array of billing services for all medical providers. No matter what you need from us, we’re ready to tackle it!

We even offer a free practice audit! 

Contact us today to get yours. You can also call us at (214) 522-0210

April 20, 2022 by smallcrowd 0 Comments

How to Do Medical Billing (And How to Let Someone Else Do It)

Without the help of a medical biller, healthcare professionals are at risk of falling behind in billing their patients for office visits. Falling behind in billing your patients can mean a loss in total revenue. For this reason, medical billing is an integral part of every medical office. 

When a doctor’s office bills a patient for an office visit, the medical biller has to submit a claim through an insurance company to receive payments for the services rendered. Medical billing doesn’t just include data entry – it takes customer service skills, attention to detail, and expertise in health insurance.

Many doctors don’t have time to take care of medical billing. That’s why every medical office should hire a medical billing company. Medical billing companies are the backbone of every doctor’s office. Medical billers and coders are there to help you get the most revenue you can out of your healthcare practice.

What Does A Medical Biller and Coder Do?

The most commonly asked question is: what exactly does a medical biller and coder do? Does a medical biller and coder do different tasks than just a medical biller? 

In a nutshell, a medical biller does the hard work of dealing with insurance claims. It’s more than likely the average healthcare professional doesn’t have time to deal with calling insurance companies and checking on the status of a claim. Medical Billers are also the ones who follow up with patients that have past due balances on their accounts.

A medical coder uses a coding textbook to code for the type of office visit that occurred. A skilled coder will be able to code quickly with minimal to zero errors. Most reputable medical billing companies will offer both medical billing and coding services.

Medical billers and coders can specifically deal with the ins and outs of healthcare insurance. They have extensive knowledge about insurance that healthcare professionals don’t have the time to learn. 

Why Should I Hire A Medical Biller and Coder?

After dealing with patients all day (and sometimes all night), no healthcare professional wants to sit down at a computer and do a ton of billing work.

To put it simply, when you bring in a medical biller and coder, you’re taking the first step to maximizing your profits as a medical business owner. Not only do billers and coders help you with receiving payments from insurance companies and patients, but they can also give you aging reports to assess how your business is doing financially. 

Medical billing and coders are usually the ones who perform a follow-up call when a patient has an overdue balance on their account. Basically, they deal with everything and anything to do with medical office finances. If anything is not right with your finances, a medical biller and coder will catch it. 

What Qualities Does A Good Medical Biller and Coder Have?

A quality, professional medical biller and coder will have either a certification, a degree, or a combination of the two. There are multiple kinds of medical billing and coding certifications that a potential employee can have – which ones you’ll prefer depends on what skills you are looking for. 

Hiring the right medical biller and coder for your company means hiring someone who has the required education and background to fill the role. 

Common Medical Billing & Coding Certifications

  • Certified Professional Coder (CPC)
  • Certified Inpatient Coder (CIC)
  • Certified Billing and Coding Specialist (CBCS)
  • Certified Coding Specialist (CCS)

Checklist for a Good Biller/Coder

  • Has a professional degree or certification
  • Has relevant experience
  • Has references to call upon
  • Knows how to use medical practice management software
  • Knows all the billing and coding lingo
  • Knows how to use the required books (especially if coding)
  • Can promptly communicate any issues to the healthcare provider

The Takeaway: Medical Billers Make Office Life Easier

Daily office life should be easy, organized, and as simple as possible for every healthcare employee involved. Work itself is already hard enough so don’t make it harder on yourself as a provider by billing your patients on your own.

It’s not uncommon for healthcare providers to breathe a sigh of relief after deciding to finally hire a medical biller and coder. Unfortunately, many healthcare providers don’t consider hiring a professional biller and coder until they are extremely behind in their billing. 

By contacting a professional medical billing service, there’s no need to continue stressing about how to manage the billing and coding part of every medical office. Medical billers and coders are a profession in high demand and with very good reason. 

April 20, 2022 by smallcrowd 0 Comments

How Long Can A Medical Claim Be Collected For?

Medical bills are something every person encounters. However, when you’re a healthcare professional running a business, medical bills need to be collected promptly to receive payment. 

One thing is for certain: as a healthcare professional, you shouldn’t deal with collecting 

medical bills on your own. The smartest way to deal with medical bills is to find a trusted medical billing company that can help sort out your finances appropriately

The best medical biller for you will be someone who can make sure you’re getting the most revenue out of your business. Medical billers want you to get paid, and it’s their job to take care of any roadblocks that are in the way of you receiving payment, whether it’s due to an insurance claim hold-up, or a patient who doesn’t have enough funds to pay up. 

How Long Are Medical Bills Collectible For?

Based on the data available on the official US census website, about 19% of America won’t be able to afford to pay medical bills right away. Non-paying patients are an aspect every healthcare professional has to deal with at one point in their career. When you have patients who haven’t paid the balance due on their account, you’re probably wondering, how long is a medical bill collectible for?

Medical bills are collectible for a period of 30-180 days. The amount of time a doctor’s office will attempt to collect payment from a patient depends on the amount of the outstanding balance and standard practice procedures for collecting late payments. 

It’s at the doctor’s office’s discretion when they decide to hire a collection agency to take care of the patient’s account. If it’s a long-time patient, the office may be more willing to work with them. If it’s a one-time patient who keeps missing appointments, the office may wait a month after initiating contact and then send it straight to a debt collector. 

What Are Reasons Why A Medical Bill Isn’t Collected?

Receiving a medical bill as a patient can be daunting. When a medical bill fails to be paid, it’s always because of the patient. The multitude of reasons a medical bill will be left unpaid is because:

  • The patient couldn’t pay for services
  • The patient refuses to pay for services rendered
  • The patient found a coding/billing error
  • The patient doesn’t understand the bill 

Patients don’t always ask the questions they should be asking, so it’s up to the medical biller to make sure the patient understands that they:

  • Owe a balance 
  • Understand why they owe that balance
  • Understand they have options when it comes to paying that balance

Clear communication with patients about the bills they owe can reduce the number of payments that go to a collection agency. Any outstanding medical debt is collectible as long as the patient is willing to pay something. 

How You Can Reduce the Impact of Medical Debt on Your Practice

A professional billing company can prevent the harmful impact medical debt can have on your practice. Professional billers can contact patients for a follow-up call, send any outstanding bills to collection agencies, and work with patients on a payment plan when needed. A lot of patients who can pay aren’t aware that they don’t have to pay the whole amount.

Before sending a patient’s account to collections, a reputable medical biller will attempt to see if the patient can pay anything on their account. Even the smallest amount can prevent an account from going to collections. 

There are solutions to prevent ongoing problems with patients who don’t pay up. Only a medical billing company can perform the necessary services to make sure you’re receiving what is owed for the healthcare services provided.

The Best Ways To Deal With Medical Debt As A Doctor

Although we love to think that all patients will always be considerate enough to pay the balance on their account, the real truth is patients can easily neglect a medical bill. Many patients are unaware that billing departments are more than willing to work with them.

Don’t opt for dealing with unpaid medical balances by yourself since you’ll only end up with a pounding headache. As a healthcare professional, it’s important to manage your time wisely by hiring a medical billing company. 

Luckily, medical billing companies know how to start the process of getting the money owed to your practice. Schedule a meeting with a medical billing professional to see how they can help keep your medical office’s finances in check. 

April 20, 2022 by smallcrowd 0 Comments

What is Medical Practice Management?

A doctor’s office is best when everyone knows what they’re doing. If the environment of the office is chaotic, it will clearly show in all aspects. This is where having a medical practice management system becomes useful. 

Without a way to handle the countless tasks that make up an average day at the office, you can expect chaos on a day-to-day basis. 

Take note of how long it takes for a current patient to get checked in. If it’s taking longer than 10 minutes to check in an old patient, your health practice could be in desperate need of medical practice management. 

Anywhere your practice could be doing something more quickly, is where you need to be proactive. Life is easier when you decide to add a medical practice management group to your office

What is the Basic Definition of Medical Practice Management?

Medical practice management is defined as healthcare software used for completing financial and administrative tasks daily. 

Running a doctor’s office efficiently means having the right resources in place, such as a medical practice management system. Patients can tell when an office is clearly disorganized and that’s the last thing you want as a doctor. 

Hiring a professional medical billing company can help with improving the overall flow of how your office runs on a day-to-day basis. Medical practice management systems are a huge reason for more healthcare providers deciding to ditch a paper filing system. 

What Can A Medical Practice Management System Do?

The facts are this, having a medical practice management system makes running your healthcare practice a breeze. Instead of having to lug around multiple, bulky files, it’s simple to find everything you need for an appointment at your fingertips. 

Patients can easily:

  • schedule appointments.
  • send a message to their healthcare provider.
  • request prescription refills.
  • Make payments. 

Healthcare providers can:

  • view/share lab results.
  • respond to any patient messages.
  • view all patient health records. 

Front desk employees will find it simple to:

  • access/edit basic patient information.
  • schedule any appointments made via phone calls quickly.
  • update patient insurance info

Skip having to manually input everything with pen and paper. This kind of medical software makes completing daily tasks easy for everyone.

What Are The Benefits of Medical Practice Management?

There’s an unlimited amount of benefits for using medical practice management. If you’re thinking that there has to be an easier way to do admin tasks, you’re right. There’s no reason to suffer from constantly losing and replacing important paper files.

The benefits you will reap from adding a medical practice management program are:

  • Enhanced Communication 
  • Instead of having to make a phone call for a simple question, patients can send a quick message to the front desk secretary, or their preferred healthcare provider. No more unnecessary games of phone tag when the patient is trying to get their lab results. 
  • Ease of Access to Patient Records
  • In older offices, you’ll notice everything is done on paper. However, with medical practice systems, all work and tasks can be completed on a tablet, laptop, and desktop computers. 
  • Automated Services
  • Front desk employees will appreciate that patients can schedule their own appointments using an online calendar, plus it only takes a couple of clicks to request a refill. 

The old days of paper filing are over, and the new days of electronic takeover in health practices have begun. You know how the saying goes: you either get with the times or get left behind. 

Patients will ultimately begin flocking to the healthcare offices that have the latest in healthcare technology. A healthcare office that’s lacking in updated technology will not only have trouble keeping patients but also have a good amount of trouble keeping up the daily workload. 

How To Incorporate Medical Practice Management Systems

The most crucial part of every doctor’s office is the software they are using to successfully run their business. When everyone can do their job the most efficiently, clients will be happy. Happy clients mean they will be back for more health-related services. 

So you want to implement a medical practice management system, but don’t know where to start? Well, it’s a simple process, contact a professional medical billing company.

Call today to get a free audit of your healthcare practice’s financial account. 

Two young women doctors sitting on the sofa
April 12, 2022 by smallcrowd 0 Comments

Why Credentialing is Important for Healthcare Professionals

Everyone from patients to business partners wants to know that the healthcare professional they’re working with is credentialed. Why credentialing is important for healthcare professionals? Here are five valuable reasons you need to consider:

Credentialing helps practices comply with regulations

There are many laws and regulations governing healthcare, and credentialing helps practices make sure they’re in compliance. For example, the Health Insurance Portability and Accountability Act (HIPAA) requires that only credentialed healthcare professionals have access to protected health information (PHI).

Why Credentialing is Important for Healthcare Professionals?

Quality of Care

When a healthcare professional is credentialed, it means they’ve met specific standards and have been vetted by their peers. This helps to ensure that patients receive high-quality care. When you are a preferred provider for health insurance companies, your practice has access to a larger pool of patients.

Credentialing Can Increase Reimbursements

If a healthcare professional is credentialed, they’re more likely to be reimbursed for their services. This is because credentialing shows that the healthcare professional is up-to-date on their training and meets the standards of care set by insurers. You need this to get paid! When your office staff is busy chasing down payments, it takes away from time that could be spent seeing patients. It also delays payments, which can impact your cash flow.

Credentialing Can Help Practices Save Money

Why credentialing is important for healthcare professionals? The credentialing process can be time-consuming and costly, but the long-term benefits of credentialing are worth the investment. Credentialed healthcare professionals can save practices money by reducing the need for duplicate testing and by avoiding potential penalties for non-compliance with regulations.

Credentialing Helps Practitioners Hospital and Medical Facility Privileges

Credentialing is often required for healthcare professionals who want hospital or medical facility privileges. This process helps to ensure that only qualified practitioners have access to these facilities. To gain entry into top facilities, you need to be credentialed.

Why Your Practice Needs Help With Credentialing

The credentialing process is important for healthcare professionals because it helps to ensure that they are meeting the standards set by regulators and insurers. Credentialing also helps to verify the qualifications of healthcare professionals, which can lead to increased reimbursements and better quality care for patients.

Unfortunately, the credentialing process can be time-consuming and complicated. That’s why it’s crucial to partner with a credentialing services company that can handle the process for you. This will save your staff time and reduce the risk of delayed or lost payments. When you’re looking for a credentialing services partner, choose one with experience in your state and with your type of practice.

AMS Solutions is a national leader in healthcare credentialing. We have over 20 years of experience working with practices of all sizes and specialties. Our staff can help your practice with all aspects of credentialing, from initial application to ongoing maintenance.

Benefits of Working AMS Solutions for Credentialing Services

There are many benefits of working with AMS Solutions for credentialing services, including:

– A team of credentialing experts who understand the process and can help you avoid common mistakes

– A cloud-based system that makes it easy to track your applications and renewals

– discounts on credentialing services for members of our partner organizations

– A dedicated account manager who will work with you to resolve any issues.

Credentialing is a critical process for healthcare professionals. It helps ensure that only qualified practitioners have access to hospital and medical facilities, saves practices money, and can increase reimbursements. When your staff is busy chasing down payments, it takes away from time that could be spent seeing patients.

Help your practice run more smoothly by outsourcing your credentialing needs to AMS Solutions. If you’re looking for help with credentialing, contact AMS Solutions today. We’ll be happy to answer your questions and provide you with a free quote.

Attractive female doctor
March 15, 2022 by smallcrowd 0 Comments

Tips for Successful Behavioral Healthcare Billing

Getting reimbursed for behavioral healthcare services can be a struggle.  The complex maze of insurance rules and regulations makes submitting behavioral healthcare billing difficult and frustrating.  This problem results in only approximately 85 percent of claims being paid.  For some, using a billing service can save their businesses.  

Billing Rules Explained

Any insurance healthcare billing system is set up to ensure that real claims get paid fully and efficiently while fake or inflated claims are weeded out.  Large group practices usually have a dedicated staff for billing; smaller practices often use third-party billing services. For service providers trying to get paid, figuring out how to comply with those systems is vital to staying in business and running a practice.    

Differences from Medical Billing

Behavioral services billing differs from medical billing because the underlying services are so different.  A specific treatment or test is billed at a specific rate in medical settings.  In contrast, in behavioral services, billing applies to therapy, medical management of patients’ illnesses, and psychological testing.  Insurers’ rules set the reimbursable length of a session, how many sessions per week they’ll cover, and usually a maximum number of sessions that will be reimbursed.  These rules do not change based on the client’s need for longer sessions or more of them.  

Most of the time, a mental health professional will wait at least 30 days for reimbursement of a submitted claim.  Also, unfortunately, service providers who contract with insurance companies usually cannot bill for the balance remaining after the insurance company pays.  The balance is simply written off.  

Clients’ insurance coverage for behavioral care changes frequently.  Service providers should be sure that clients know they should inform the provider of such changes.  Often, however, even the client isn’t aware of changes.  Thus, you as the provider should check your clients’ coverage frequently to see if you need to make changes in your billing practices.  It is better to change your treatment plan than to implement it and find out it won’t be reimbursed.  

When considering how to handle your client payments, think about any given insurer’s pre-approval rules and their limits for payments.  Make sure you understand the length of the session they will cover and the number during each billing period and over the life of the illness.  The more you work with given providers, the more likely you are to do things as they like them.  

How a Billing Service Can Help

You can avoid many of these headaches by using a behavior healthcare billing service.  They can improve your collection rates of return and get you to nearly 100 percent successful collections.  Services they can offer include:

Tracking patient demographics, onboarding, and insurance verification

It’s not enough just to have patients.  You have to properly bring them on board, know who they are, and make sure they have insurance that covers your services.  A behavioral healthcare billing service can handle this for you, leaving you free to provide services to these new clients.  

Managing accounts receivable

Behavioral healthcare billing services let you focus on treatment while they manage your accounts receivable.  As they do billing and receive revenue, the service will discover problems and remedy them before real damage to your practice results.  

Obtaining physician credentialing when required

A healthcare billing service can make sure that all of your workers are properly credentialed.  They can also ensure that each service billed was performed and billed by a professional with the appropriate credentials for that service. As you add new professionals to your practice, it’s vital to ascertain that they are properly credentialed to provide those services.  

Auditing codes for maximizing revenue

Proper coding is the heart of getting paid in healthcare billing.  When you have a patient in your office, you record the visit or service in the client’s file.  You include an explanation of why you gave that specific service, test, or procedure.  Your healthcare billing service will work from that record to review and document your clinical records to ensure that the file is complete and that they obtain any missing information.  The service will then apply the correct ICD diagnosis and CPT or HCPCS treatment and procedure codes to the patient’s condition and file the claim.  The billing service then compiles this information under a chargemaster capture code that sets the standard prices for services and procedures you provide.  

Reporting on revenue collections

Your healthcare billing service can keep you current on the success of your collections by providing periodic reports on revenue collections.  If there are problems with particular insurance companies or patients, these reports will reveal that to you.

In sum, behavioral healthcare billing allows you, the mental healthcare professional, to concentrate on providing behavioral healthcare.  Meanwhile, someone else devotes time and effort to ensure that you are well-paid for doing so.  

patient listening intently to a male doctor explaining patient s
March 4, 2022 by smallcrowd 0 Comments

Why You Need a Medical Billing Company

8 Reasons You Should Outsource Medical Billing 


Medical practices of all types and sizes are tasked with helping patients feel their best. Ideally, the success of any doctor or group practice should be measured solely by the level of care received by the doctor. Still, the importance of revenue cannot be understated.

It only takes a few medical billing errors to result in an unstable revenue workflow. A disruption in cash flow can be detrimental to any size of medical practice. Because of this and the workload of medical billing, many practices outsource this service to a medical billing company. The benefits are undeniable.


A medical billing company can help the medical practice:


1. Provide the attention and expertise needed to handle the billing load.

 Medical billing companies are experts at handling billing. They know the intricacies of private insurance companies, Medicare and Medicaid. They are educated on the ever-changing coding and billing regulations. Many companies have account specialists for different types of medical practices. In short, the medical billing specialists act as the bridge between the medical practice and the insurance company, making sure the practice gets paid. 


2. Keep the focus on patient care and the provision of quality healthcare.

 After all, patient care should be the top priority in your practice. Medical billing companies handle patient and payer inquiries so you can stay focused on what’s important – allowing your staff to hone in on their day-to-day functions with patients. 


3. Process claims efficiently and quickly.

 Medical billing companies know the ins and outs of medical coding and insurance companies since that is their expertise. Because of this, they can process claims at a much faster and more efficient rate. 


4. Maintain the biller-patient relationship in a trust-filled atmosphere.

 Because medical billing companies handle all of the inquiries from patients and payers, your focus as a medical practice can be solely on the patients’ medical needs. This creates a trust-filled atmosphere without the stress of financial worry.


5. Increase cash flow for the practice.

 Medical billing companies work with your practice to ensure consistent cash flow and optimize revenue potential. Claims are constantly being processed and filed by an outsourced service. If you have in-house billing and one employee is out on vacation or sick for any amount of time, your claims will get backlogged. Backlogged claims disrupt cash flow. 


6. Increase revenue.

 The specialists can improve the practice’s overall revenue performance by bringing money that may otherwise go to collections. By outsourcing this area of work, you can have a more controlled and sustainable approach to revenue cycle management.


7. Provide peace of mind for the medical practice owner.

 The medical practice owner can feel a sense of peace once they decide to work with a medical billing company. They don’t have to worry about their in-house specialists staying up to date on medical and billing codes or insurance claims. They also don’t have to worry about staying up-to-date on software. 


8. Save money on office space and salaried employees.

Outsourcing medical billing is the perfect solution for a practice that does not want to hire and maintain billing personnel. A lot goes into having your in-house billing department- from training costs, benefits, insurance, and payroll, to hardware/software installation costs. Medical practices can also skip costs on office supplies and furniture.


When medical practices don’t have to worry about billing, they can focus on what matters. Regardless of company size, medical billing outsourcing is a fantastic solution for your practice. Outsourcing medical billing can eliminate interruptions and distractions that would otherwise prevent you from reaching your potential. It also scales with your business, so growth is possible and manageable.