Medical billing is a critical component in the healthcare industry, bridging the gap between healthcare providers and insurance companies. It’s a process that ensures medical professionals are compensated for their services. However, as with any rapid-evolving industry, the various complexities and nuances involved can pose challenges for many medical practices, leading to delayed or denied claims, which in turn affect the cash flow and overall financial health of the practice.

This is where medical billing companies come into play. They take up all of the administrative work needed for the billing and coding, which would normally be done by in-house staff, allowing the workforce of a healthcare provider to focus more closely on the care they provide to their patients. We’re going to look at what these medical billing companies do, how they work, and look at how outsourcing medical billing can help your business. 

What Do Medical Billing Companies Do?

Medical billing companies are one of the most effective ways to streamline a provider’s reimbursement process and shorten the billing and payment cycle. They are responsible for taking the medical services and procedures that are performed, translating them into the industry standard codes, and submitting claims for reimbursement. 

The journey of a reimbursement claim typically begins with patient visits, where coders convert the diagnoses and treatment details into universal medical codes. Following this, medical billers prepare the claims, ensuring they are error-free and compliant with insurance regulations before submitting them to the respective insurance providers.

Most medical billing companies will also follow up on submitted claims, address any denials, and ensure that the healthcare providers are reimbursed accurately and promptly. They can offer other administrative services as well, like analytics, collections, and more. 

Is It Important To Have A Medical Billing Company For My Medical Practice?

For most small and mid-sized practices, the importance of partnering with a dedicated medical billing company is hard to overstate. They serve as a buffer, ensuring that your medical practice remains financially stable and compliant with ever-evolving healthcare regulations. Medical billing companies possess the expertise to handle complex billing issues, reducing the likelihood of errors that could lead to claim denials or delays. They also free up time for your medical staff, allowing them to focus on patient care rather than administrative tasks.

Benefits of Hiring a Medical Billing Company for Your Practice

Providers that outsource their medical billing needs to a dedicated billing company can reap a range of benefits. Here are just a few of the benefits that your organization could see:

• They have the expertise and technology to scrutinize every claim for errors
• They stay updated on the latest coding standards and insurance policies
• They can actionable insights into your billing processes
• They allow your staff to focus on your patients

How AMS Solutions Leads In Effective Medical Billing

AMS Solutions is seen as a leader in the medical billing field and employs a team of dedicated and specialized professionals. Our specialists nimbly navigate the complex landscape of healthcare billing. We take the time to tailor our services to match the unique needs of each medical practice, ensuring a seamless billing process from patient visits to final reimbursements. We also lean on cutting-edge technology to ensure accuracy and compliance in every claim, significantly reducing the chances of delaying or denying your payments. 

Trusting another entity with your medical billing and coding needs is a big step for any practice, but even more so for practices that don’t have money to waste. However, partnering with AMS Solutions is a step towards financial robustness and operational efficiency for your medical practice. Let us help you elevate your practice to the next level of provider service, reach out to AMS Solutions today.

The processes of medical billing and coding are critical to the healthcare industry, but there are still countless people who wonder what do medical billing and coding do. The job actually requires a substantial blend of medical knowledge, technical skills, and attention to detail, and it helps make sure that healthcare providers are paid accurately and on time for the services they render.

In this post, we’ll be taking a more in-depth look at the job of medical billing and coding, and the processes behind them. We’ll also look at some of the challenges that can pop up from time to time, and how a billing and coding administrator like AMS Solutions is prepared to help your organization scale rapidly.

Understanding The Job Of Medical Billing and Coding

To get a better idea of what medical billing and coding are, you’ll need to understand that both are distinct but closely related functions within the healthcare industry. 

Medical billing involves the process of creating billing claims from provided healthcare services and submitting these to insurance companies for reimbursement. On the other hand, medical coding is the translation of medical diagnoses, procedures, and equipment into universal medical alphanumeric codes. These codes provide a standardized language, which is essential for ensuring accurate billing and record-keeping.

The symbiotic relationship between billing and coding ensures that healthcare providers are reimbursed accurately and promptly, which in turn, supports the financial health of medical establishments. Both functions are critical in maintaining the integrity and efficiency of the healthcare financial ecosystem, easily illustrating why the field is critical.

The Process of Medical Billing

The process of medical billing is pretty meticulous. When a patient visits a healthcare provider, their demographic and insurance information is recorded. Afterward, all of the information is used to generate a bill that delineates all of the services rendered and their costs. This bill is typically then submitted to an insurance company for review and eventual payment. One of the biggest factors in the process is the intricacies, which demand a high degree of accuracy to ensure proper reimbursement.

The Process of Medical Coding

Medical coding, the counterpart to medical billing, is equally vital in the healthcare reimbursement cycle. It entails recording the various diagnoses, procedures, and treatments into codes that are universally recognized. These codes form the basis of billing and ensure that the services provided are accurately represented and reimbursed. The coding process begins with the review of medical documentation from which the relevant codes are derived and then used in the billing process. Accuracy and timeliness in coding are paramount to prevent claim denials and delays in payment.

How AMS Solutions Can Assist

AMS Solutions is one of the most trusted and proficient medical billing and coding administrators by creating a team that is well-versed in the latest coding standards, billing regulations, and insurance requirements, ensuring that your medical establishment remains compliant while optimizing revenue collections. We help alleviate the heavy administrative burden that comes along with having to keep an in-house billing and coding team up to the demands of an ever-changing industry. This way, you’ll be able to focus on what matters most, providing the care you’re known for. 

Partner With AMS Solutions For Hassle-Free Billing and Coding Administration

Understanding medical billing and coding is crucial for maintaining the financial viability of any provider. The intricate and often confusing practices involved in billing and coding are the linchpins of the entire healthcare reimbursement cycle. If you think it may be time for your organization to leave the billing and coding to the professionals and focus on your patients, reach out to AMS Solutions today. 

If you’re an administrator for a healthcare provider or operate your practice, you’ve probably asked yourself, “Should I outsource my medical billing?”, and if so, you’re not alone. In the constantly evolving field of healthcare, countless healthcare professionals grapple with this question every day. Effectively navigating the ocean of complexities of medical billing can be intimidating, overwhelming, and worst of all, time-consuming. So many providers are turning to outsourcing as a solution for their medical billing workload, but is it the right decision for your practice? That’s what we’re going to look at here, so let’s get to it.

Biggest Benefits Of Outsourcing Medical Billing

While each practice will undoubtedly see benefits unique to its operating circumstances and needs, some of the biggest benefits will be seen across most providers. Here’s a look at the most common and prominent benefits nearly every practice can appreciate. 

Time Savings and Efficiency

Without a doubt, one of the biggest benefits of partnering with an outsourced billing provider is the amount of time you can potentially save by outsourcing your medical billing workload. When healthcare providers try to manage billing in-house, the process can be exhaustive, requiring them to balance patient care with tedious administrative tasks.

Outsourcing frees up your in-house team to focus on their core duties. Your front desk team won’t have to juggle billing and appointment booking, and your patient care team won’t need to mix exam room time with 

Access to Expertise and Reduced Errors

Outsourcing your medical billing also gives you access to an army of professionals who specialize in just that. At AMS Solutions, we take pride in being able to deliver our team’s accuracy, up-to-date billing regulations knowledge, and speed, to practices that need help effectively managing their administrative work. This all adds up to fewer errors, quicker payments, and overall smoother daily operations. 

Financial Savings

Another critical point of medical billing outsourcing, and whether or not it’s the right choice for you, is the cost-effectiveness of outsourcing versus keeping the work in-house. Hiring an in-house billing team will, at the very least, require screening candidates, allocating salaries, paying for benefits, conducting onboarding, supplemental or ongoing training as needed, and core infrastructure costs. For small or even medium-sized practices, this can lead to a substantial investment.

In contrast, outsourcing can eliminate virtually all of these challenges or costs for your practice. Your billing team comes already screened, trained, and ready to handle your office’s billing needs. This cuts your overhead down by a considerable margin, makes your costs more predictable, and allows you to shift the cost out of payroll and into a monthly service expense.

Why AMS Is the Leader in Medical Billing Solutions

AMS Solutions is renowned for delivering highly accurate, efficient, and reliable medical billing and collection services. Our robust technology, coupled with our team’s profound expertise, ensures your practice remains compliant while also increasing your revenue. We also stay up-to-date on all billing regulations and industry best practices, so that you don’t have to and so that your business can steer clear of violations and penalties like fines. 

Partner With The Medical Billing Leader For Your Billing & Collections Needs

So, should you outsource your medical billing? The benefits are clear: increased efficiency, access to expertise, cost savings, and more. AMS Solutions places as high of a value on your practice’s success as much as you do, providing superior service to help you focus on what truly matters, and giving your patients an unbeatable level of care. Reach out to AMS today for a free consultation, and allow us to design a customized solution to enhance your practice’s financial health while you concentrate on the rest of your practice.

The healthcare field has never been simple or stationary, but today’s rapidly evolving healthcare landscape is introducing numerous complexities for medical professionals of all types around the world. One of the most crucial aspects of any provider or practice is medical billing and collections, which is a domain that poses a significant challenge for many administrators. If you’re still wondering “What is medical billing outsourcing?” don’t worry, we’re going to get into it. We’ll shed some light on what it is, as well as look at why it’s becoming so popular in recent years. 

What is Medical Billing Outsourcing?

Medical billing outsourcing is the act of delegating your medical billing and collections tasks to an external, third-party agency that specializes in medical billing for various specialties. Agencies like AMS Solutions then take on the responsibility of providing accurate and timely billing, ensuring that your payments are submitted, processed, and received promptly and accurately, and minimizing errors and claim denials. 

Advantages of Medical Billing Outsourcing

Medical billing outsourcing is a strategic move that offers an array of benefits designed to simplify operations and boost your practice’s efficiency and profitability. Each practice will see benefits that are often related to the unique challenges they face, however, there are many advantages that can be seen across practices and specialties. Below are a few of the more significant benefits. 

1. Focus on Core Healthcare Services: One of the key benefits of outsourcing is that it allows your healthcare team to focus on their core job duties of providing care to your patients. Medical billing is a meticulous and time-consuming task that requires a unique set of skills that aren’t usually commonplace in other roles. By outsourcing this aspect of your practice, your team can dedicate their time and energy towards providing top-tier healthcare services, enhancing patient satisfaction.
2. Cost-Efficiency: Investing in state-of-the-art billing software and hiring a dedicated team for in-house billing can bring significant financial burdens to your practice. However, by outsourcing your medical billing, these upfront costs are eliminated and you only pay for the services you need, providing excellent value for your money.
3. Steady Cash Flow: The efficiency and consistency of a dedicated billing agency can ensure a steady cash flow. With an outsourced team working around the clock, there are no delays due to staff shortages, vacations, or unexpected absences. Your billing process continues as long as you’re taking patients, keeping your revenue cycle robust and predictable.
4. Expertise and Compliance: A specialized agency like AMS Solutions brings years of expertise to the table. We stay updated with the constant changes in healthcare regulations, insurance policies, and medical billing codes. Our knowledge and expertise can help prevent costly errors, ensuring compliance and saving your practice significant amounts of money.
5. Access to Advanced Technology: Finally, when you outsource your medical billing, you get access to advanced technology without the need to purchase and maintain it. Agencies like AMS Solutions utilize cutting-edge software to ensure accuracy, and efficiency, and to provide detailed reports for your convenience.

Partner With A Medical Billing Leader To Future-Proof Your Practice

AMS Solutions is a leading provider of medical billing outsourcing services that encompass everything from new patient registration, insurance validation, and verification, to claim submission and even follow-ups to aging claims. Our team is expertly trained to handle any billing scenario so that you and your practice always receive payments due in a timely and efficient manner.
If you think you and your practice may be ready to take the next step in optimizing your billing process, AMS Solutions may be the best choice for your business. Reach out today for more information or to discuss how we can help your practice meet its billing needs.

Medical billing, one of the most critical components of the healthcare industry, involves complex terminology that often has the ability to confuse even long-time professionals. One of these terms that we’ll be taking a look at is the ICN. If you’ve been wondering “What is ICN in medical billing?” or “What is an ICN number?” then stick around. We’re going to do a deep dive into this term, what it means, and why it’s so important to medical billing. 

ICN in Medical Billing: A Snapshot

Inside the world of medical billing, every single transaction,  no matter what it’s for, is tracked with unique identifiers, from the average patient visit to complex or intricate surgical procedures. The ICN, short for Invoice Control Number, is a unique identifier that functions similarly to a tracking number on a shipped parcel. It helps insurance companies monitor claims by giving them access to each individual claim.

Unraveling the ICN Number

So what is the unique significance of the ICN, and why should medical practices care about understanding the specifics behind them? The ICN serves as one of the key reference points throughout the entire claims process. It’s uniquely assigned to each claim that’s created, allowing insurance providers to track its status more effectively. 

When a healthcare provider submits a claim to the insurance company, no matter what the reason, the claim is tagged with an ICN. This unique number stays with the claim from initial submission through the final adjudication, which provides a clear and consistent point of reference for the insurer.

Why is ICN Crucial in Medical Billing?

Knowing “what is ICN in medical billing” is critical information for seamless operations. It helps aid in tracking the claim’s journey, investigating any discrepancies, and facilitating effective communication between various healthcare providers and insurance companies. ICNs are especially beneficial when a claim gets denied or requires reprocessing. 

The ICN number serves as the claim’s unique identifier, simplifying the process of locating the claim in question. Therefore, having a clear and thorough understanding of the answer to the question of “what is an ICN number” is a central component to efficiently navigating the complex landscape of medical billing.

AMS Solutions Has Leading Skills and Expertise in Medical Billing

At AMS Solutions, we have a unique and unmatched understanding of the nuances of medical billing. We know that comprehending terms such as ICN can be challenging, but it’s also integral to your practice’s financial health. That’s why we offer comprehensive medical billing and collections services, designed to help you navigate the system with ease.

We not only explain what ICN is in medical billing, but we also manage all aspects of your billing cycle. From claim submission to track, from denial management to reprocessing, we handle it all. We’ll take care of the complexities so you and your staff can focus more intently on what it is that you do best, which is providing leading care to your patients. 

Harness the Power of Effective Medical Billing with AMS Solutions

Understanding what is an ICN in medical billing is crucial for the effective and efficient management and tracking of claims. As a unique identifier, the ICN serves as a vital tool not only for communication but also for the resolution of discrepancies between healthcare providers as well as insurance companies. 
At AMS Solutions, we’re fiercely passionate about helping your organization to succeed by helping to simplify and streamline the complex tasks associated with medical billing and coding. We’re ready to handle all of your coding, billing, and collections needs so that your time can be better spent improving the health and lives of your patients. Reach out today for more information or to get started.

Navigating the complexities of medical billing can be a daunting task for any healthcare provider, and chief among these complexities is gaining a clear understanding of the answer to the question “What is entity code in medical billing?” With the right information and guidance, it’s easier than you might think to master this critical aspect of the medical coding and billing process. AMS Solutions is ready to help, and our expert team can help you simplify and streamline your organization’s overall medical billing accuracy and effectiveness. 

What is Entity Code in Medical Billing?

An entity code, simply put, is a unique identifier assigned to a particular entity involved in a healthcare transaction. This can include healthcare providers, patients, insurance companies, or any other organization involved in the transaction. Having clarity about the role of the entity code in medical billing is vital to ensure accurate and efficient billing processes.

In the world of medical billing, entity codes are critical in streamlining the transaction process. They ensure that every billable service rendered, and every entity involved, is accurately represented, recorded, and processed. Moreover, having the right entity code in place can prevent delays or denials of insurance claims, thereby improving the revenue cycle of your healthcare practice.

Why is Entity Code Important in Medical Billing?

The core significance of the entity code in medical billing cannot be overstated. Accurate coding ensures a smooth and efficient billing process and eliminates possible confusion or miscommunication. This is crucial because a single error in the entity code can lead to dramatic consequences, including incorrect billings, delayed payments, and even denials for claims. 

AMS Solutions recognizes the critical importance of setting your coding and billing right, the first time, every time. With our comprehensive medical billing and collections service offerings, you can rest assured that each and every entity code is correct, that every claim will be processed promptly, and that every dollar owed to you is collected as efficiently as possible.

Choosing AMS Solutions for Your Medical Billing Needs

When you consider what entity code is in medical billing, the complexity can be intimidating or even overwhelming. However, with AMS Solutions, we can help take the burden off of your shoulders. Our expert team of healthcare billing professionals is incredibly skilled at managing the intricacies of entity codes in medical billing, making sure that your billing process is smooth, efficient, and as error-free as possible.

Our services extend well beyond simply helping to manage entity codes. With AMS Solutions, you get a partner who understands every single aspect of medical billing. Our team’s experience, expertise, and commitment to your success, ensure that your revenue cycle is optimized for maximum profitability.

AMS Solutions Is Ready To Be Your Trusted Medical Billing Partner

Understanding what entity code is in medical billing and its importance is key to a successful medical billing process. But you don’t have to navigate these complex waters alone. With AMS Solutions, you get more than just a service provider; you get a partner dedicated to your success. Our proficiency in managing entity codes and all aspects of medical billing and collections ensures that you can focus on what you do best, bringing leading care to patients.

Don’t let the complexities of medical billing slow you down. Choose AMS Solutions for all your medical billing and collections needs. Contact us today to learn more about how we can support your practice. Remember, with AMS Solutions, you’re not just optimizing your revenue cycle; you’re building the future of your healthcare practice. Make the right choice for your practice. Contact AMS Solutions today for more information or to get started.

The world of healthcare is complex and far-reaching, and managing the financial end of any practice can be a challenge. One of the most common questions that healthcare providers often ask is: “How much do medical billing companies charge?” At AMS Solutions, we believe in peak transparency, so we’re here to talk about that very subject. We’re going to take an in-depth look at the costs involved with partnering with a medical billing company. 

The Cost Variation

The first thing that is critical to understand is that not all companies charge the same rates, or even similar rates in many cases. Not only that, but some don’t even have the same pricing structure, so one company might charge or bill you in a completely different way for their time or services than another. Other factors should be considered when looking at the variance between what one company charges and what other charges. 

Percentage-Based Charges

One of the most common pricing structures for medical billing companies is the percentage-based structure. This means that when they need to figure out how much to charge for billing services, they simply look at the gross revenue for the practice, and charge a percentage of that. In most cases, percentage-based medical billing services will charge between 3% and 7% of the practice’s gross revenue. 

This model makes it easy for the billing company to align its interests with those of your practice. But it also leads back to the question: how much do medical billing companies charge in real terms? For example, let’s say your practice generates roughly $720,000 each month in revenue, and your medical billing service charges 5% of the gross revenue. You’ll be paying about $36,000 in billing service costs each month.

Flat-Fee Model

While less common, many medical billing services operate on the flat-fee model. AMS Solutions offers some flat-fee service plans, which can offer a far more predictable, fixed monthly cost for your practice. This is often a far more cost-effective solution, particularly with small and mid-sized practices, since it doesn’t fluctuate with the monthly revenue levels. This gives more stability and consistency to practices that need them the most. 

How Much to Charge for Billing Services?

Another question that frequently pops up is how billing service providers determine how much to charge for billing services. The answer to this can vary quite a bit, depending on factors like the total number of patients in a billing cycle, the complexity of the billing process, and the level of administrative support that’s needed to complement the billing. In most cases, billing service providers will charge anywhere between $1 and $10 per claim handled, with most averaging right in the middle of that range. 

Why Choose AMS Solutions?

With the constantly shifting healthcare landscape, and the often changing demands of small to midsize healthcare provider practices, choosing AMS can be one of the smartest moves you can make for your organization. We provide comprehensive coding and billing expertise which means you can focus on what matters for your practice, providing top-tier attention and care for your patients. Our competitive pricing and exceptional service and client satisfaction level mean you’ll always be getting the best value for your billing with AMS.

Trust AMS With Cost-Effective Management of Your Medical Billing Needs

Understanding how much medical billing companies charge can be a relatively complex process. However, with the right information and a trusted billing partner like AMS Solutions, it doesn’t need to be overwhelming. Reach out to AMS Solutions today for more information, or to get started discussing your organization’s needs.

Do you run a healthcare provider practice and find yourself wondering, “What do medical billing companies do?” The good news is, you are not alone. With the continual expansion and growing complexity of the healthcare industry, the need for specialized services like medical billing and coding has risen dramatically over the past few years. 

But, what exactly do these companies do, and how do they function in our modern healthcare system? Let’s take a look at those questions, as well as why you should consider outsourcing your billing needs to one and what kind of benefits it may be able to offer.

The Basic Role of a Medical Billing Company

In the most basic sense, a medical billing company acts as a middleman between healthcare providers, their patients, and the insurance companies. They ensure that medical procedures that are performed are coded correctly in the records, the claims are submitted accurately and on time, and that the payments are collected promptly. 

This process might seem simple and relatively straightforward, but in reality, there is a substantial amount of attention that is paid to the detail and the understanding of the assorted medical and insurance protocols.

What Does a Medical Billing Company Do On A Daily Basis?

While this may not reflect the typical day at all medical billing companies, it will give you a general overview of the various tasks that are involved. The first step is patient registration, where essential personal patient information, along with insurance information, is recorded and checked for eligibility and coverage. 

Next, comes the medical coding. In this step, the medical billing company translates the diagnoses and various procedures or treatments into the standardized codes that insurance company computers understand. This step is critical since any errors at all can lead to claim denials. 

The next step is claim submission, where the medical billing company will submit the claims to insurance companies to be reimbursed for the services they’ve rendered. This step has the potential for claim rejection, and if a claim is rejected, the billing company will often simply correct the error and resubmit the claim automatically. 

Finally, the last step is the payment posting and any follow-up that’s needed. The billing company will post payments received and will follow up on claims that are unpaid and extend the revenue cycle. They will also usually handle the usual patient billing inquiries, which can range from simple to highly complex, given the intricacies of insurance coverage and individual policy specifics.

Why You Should Consider Outsourcing Medical Billing

Now that you know what a medical billing company does, in general, and on a daily basis, you might be starting to wonder what the benefits are of outsourcing that particular workload. One of the biggest advantages is that it frees up your staff and healthcare provider partners to focus on what they do best: providing industry-leading care for your patients. 

Additionally, specialized medical billing companies like AMS are uniquely qualified to maximize your practice’s revenue and reduce overall error rates for claims. They keep their teams up-to-date on all of the constantly-changing industry regulations and compliance requirements, which helps ensure that your practice will never face penalties for violations or non-compliance. 

Finally, outsourcing your medical billing services can lead to substantial cost savings. By eliminating the need to spend in-house staff time and payroll dollars to manage billing needs, practices can save on salaries, benefits, and even hiring, training, and onboarding. 

Partner With AMS Solutions for Your Medical Billing Needs

AMS Solutions is one of the leading providers of medical billing services and can help you streamline your organization’s billing operations. For more information on the benefits your practice can see, or to get started making the switch, reach out to AMS Solutions today.

At AMS Solutions, we understand more than most that dealing with unpaid medical bills can be one of the most stressful, confusing, and even overwhelming tasks, particularly when there are problems with getting the bills paid by your insurer. You may even be at the point where you’re wondering, “Can you sue an insurance company for not paying medical bills?” This question is a lot more common than you may think, particularly when patients may find themselves stuck in a frustrating situation with their insurance providers. 

Understand Your Rights

First of all, you must understand your rights, however, the insurance landscape can be incredibly complex. In some cases, the answer to “Can I sue my medical insurance company” is a definite yes. That said, like many other things it is not as straightforward as it seems. 

Before rushing out to file a lawsuit, however, you’ll need to ensure that you’ve exhausted all of the other possible solutions or remedies. This can include filing an appeal directly with the insurance company, seeking the intervention of an insurance regulator, or even getting a patient advocate involved. 

When Can You Sue an Insurance Company?

If your insurance provider is not adhering to the terms of the contract that they hold with you, your insurance policy, then it is possible to sue for a breach of contract. This is often the case when a particular insurance company denies a claim without any reason, when they’re delaying payment intentionally, or when they refuse good-faith out-of-network rate negotiations as may be required by their policy. The biggest hurdle is that the legal process can be lengthy and quite costly to pursue in some situations. This is where the services AMS Solutions provides can be of incredible value.

The Value of Expert Assistance

When you’re dealing with an issue as serious as unpaid medical bills, expert assistance can make all of the difference in your case. If you’re asking “Can I sue my medical insurance company?”, it may be time to talk to a professional about it. AMS can offer you that much-needed assistance. We are well-versed in the intricacies of insurance policies and have a solid track record of helping to resolve complex billing issues. 

How AMS Solutions Can Help

The expert billing professionals at AMS have extensive expertise not only in coding and billing but in collections. This means we’re uniquely equipped to help you navigate the incredibly complex billing situations that have you wondering if you can sue your insurance company for not paying your medical bills. 

We can help you explore viable solutions, and our team of insurance experts can review your coverage, and help identify any potential inconsistencies in the denial issued by the insurer. For those trying to appeal insurer determinations, this can be invaluable. In many cases, it can even lead to a satisfactory resolution without resorting to legal action. 

The Best Course of Action – Partnering With AMS

Can you sue an insurance company for not paying medical bills? While the answer is yes, it’s important to remember that it should be the last resort. It’s often found to be more cost-effective and more efficient overall. This is generally because the more efficient and cost-effective option is to resolve these issues with the help of experienced and trusted professionals, like the ones at AMS Solutions. 
Instead of feeling overwhelmed by the prospect of legal action against your insurer, why not start with more manageable steps? First, reach out to AMS and let us help you explore your options and find the best solution together.

Every industry is rapidly moving toward complete digitization, and the healthcare industry is certainly no exception. Unfortunately, a world that is moving constantly toward more digital solutions will undoubtedly face mounting concerns over growing problems like medical billing fraud. 

We’re going to take a look at what exactly medical billing fraud is, as well as go over a step-by-step walkthrough of how to report it. We’ll also discuss how AMS Solutions is uniquely positioned to be an effective, ethical, and error-free partner in outsourced medical billing. 

What Is Medical Billing Fraud?

Medical billing fraud typically involves false claims or statements being made in relation to healthcare services. This means medical billing fraud can take many different potential forms, including billing for services not performed, double billing, or misrepresenting the services rendered. Fighting these unethical and illegal practices helps to be able to recognize and report instances of medical billing fraud.

How to Report Medical Billing Fraud: A Step-by-Step Approach

1. Document Everything: The first and most important step in billing fraud reporting is documentation. Keep a record of every detail related to the suspected fraudulent billing. This includes dates, service descriptions, amounts billed, and records of any conversations you had with providers or insurers.
2. Contact Your Insurance Company: Once you have gathered together all of the needed information and documentation, the next step is to contact your insurance company. They will generally have a dedicated fraud reporting hotline, and they will guide you in their specific fraud reporting process. 
3. Report To Authorities: If your insurance company doesn’t, or isn’t able to, resolve the issue, or if you suspect they may be involved in the fraud, it’s important to escalate the matter to the appropriate local, state, or federal authorities. This can include the state insurance commissioner’s office, the Federal Trade Commission (FTC), or even the Office of the Inspector General (OIG).
4. Get Legal Help & Representation: If the fraud has resulted in you suffering financial harm or other measurable damages, you may have the right to pursue compensation, but you’ll likely need to get an attorney involved. Consulting with a lawyer will often not only be able to get you answers to your questions, but it can get you guidance on the process, and may even result in the attorney taking the case on contingency.

Partner with AMS Solutions for a Fraud-Free Experience

Understanding how to report medical billing fraud is a critical skill in the modern highly digital healthcare landscape. By staying highly vigilant, you can help fight this unethical practice, ensuring that everyone pays their fair share for healthcare services. Remember, however, that prevention is the best strategy, and while understanding how to report medical billing fraud is essential, doing everything you can to prevent it is even better.

Partnering with one of the most trusted leaders in the medical billing services industry, like AMS Solutions, can go a long way toward providing you with peace of mind regarding your practice. Choosing a reliable billing partner like AMS means that you can count on your coding, billing, and collections to be handled in a professional, ethical, and legal manner that helps protect patient data integrity and security.
At AMS Solutions, we’re also committed to transparency and integrity in all aspects of our operations. We adhere to all local, state, and federal regulatory requirements, and ensure that all billing practices we engage in are accurate and compliant. We employ a robust checks and balances system to prevent any chance of fraudulent activity, providing a safe and reliable billing service for all of your organization’s needs. Reach out to AMS Solutions today to learn more or to get started making the switch.