Medical Billing Company: Everything You Need To Know

Medical Billing Company: Everything You Need To Know

When it comes to your billing needs, hiring a medical billing company may be the best option. Nitin Chhoda shares the important factors that you need to consider whether you’re going to hire a medical billing company or an independent contractor, and how your preferred billing system plays a key role in that decision.

medical billing company definitionMedical billing company is not easy to find and medical billing is no easy job. But for many small medical practices, adding billing to your list of things to do can be overwhelming.

Especially for practices that are just getting started, hiring a medical billing company can be cost-effective and will take a lot of stress out of the process of starting and running a business.

Just like hiring an accountant to do your taxes, when you hire a medical billing company, you are handing off a very important task to an expert in the field.

Price Isn’t Everything

Of course, when you hire a medical billing company, the hope is that you will be paying them less than you would pay a full time medical biller as part of your staff. Giving yourself some financial ground rules or even estimates will help you to determine how much money you should pay a medical billing company for the services they provide.

Medical Billing Companies Should Provide Typical Rates

But in addition to doing the job, they’d better do the job really well. Many medical billing companies will guarantee a certain rate of accepted claims. If they don’t actually guarantee a certain rate, they may at least give you their typical rates of rejected and denied claims so you can tell what kind of job they are doing.

Typically, insurance companies will reject about half of all claims, so even with a professional medical billing company, your expectations shouldn’t be too high. And remember that the time and effort that it takes to handle medical billing really is worth more to you than the cost of hiring a medical billing company to do the work for you.

Medical Billing Company or Independent Contractor

Some smaller practices may have the option of hiring an independent contractor who works part time and remotely. This option can also be cost effective, especially if the price is right.

In many ways, you will have to work out the details more thoroughly with an independent contractor, which may result in better outcomes for billing. But the convenience of medical billing companies is often a big factor in making the decision of who to hire.

medical billing companies

More important than the size of the medical billing company, be sure to hire someone or a company that has a lot of experience and a proven track record.

Your Options

If you are trying to choose between an independent contractor with ten years of experience or a brand new medical billing company that has been around for less than a year, make sure that the employees at the medical billing company have more experience before you take that route.

A medical billing company may have a more standardized system and it may be easier to integrate your data system with theirs, but if they are new to the work and do not bring in the payments that are owed to you, nothing else will matter.

Make sure that whoever you hire can send you reports from their previous work as well as reports for the work they do for you, so you can see how the work is going, too
.

Medical Billing Company Is Easier With an EMR

Medical Billing Company Is Easier With an EMR

To make your EMR more convenient, integrating it with a medical billing company is a good option.  NItin Chhoda explains why connecting your EMR system to a medical billing company software will make it easier to use.

medical billing company EMRThere are many advantages of electronic medical records and one of the most often emphasized is the advantage for medical billing staff.

Everyone else in the office can be a bit faster and more efficient, and the medical biller can process information much more smoothly.

But having an EMR isn’t just for those medical practices that do their own billing. Even if you hire a medical billing company, having an EMR will have distinct advantages over processing billing any other way.

Information Integration

The only challenge of hiring a medical billing company is deciding how the critical notes and information will be transferred from your practice to the medical billing company.

The billers will need a lot of information from your practice, and to ensure that information is accurate, you will need to integrate your information systems. It’s possible that this will not be an issue if you have a high quality EMR that records all of your information already.

Make It Digital

If clinicians are recording their appointments and notes using digital media, then the first step is already taken care of. The only question will be how to transfer the information from your practice’s EMR to the medical billing company.

Most medical billing companies will have experience with a number of EMR systems and with figuring out a transfer system. If you hire an independent contractor to handle your medical billing, rather than a medical billing company, they may be willing to adopt your software, making the process incredibly simple. And of course, if your EMR is online, then all the biller will need is access to the site.

Software Developed by Medical Billing Companies

There are also a number of medical billing companies that have decided to design their own medical billing software. This has distinct advantages for the medical billing company.

They can customize the software to suit their needs and preferences. Customized software can be a bit harder to get used to, but in the end it should work better than any other solution on the market because it will be designed with very specific needs in mind.

It’s possible that your practice will need to integrate your system with the custom system that the medical billing company is running.

medical billing companyIntegrated Solutions

Usually, they will have the solution already, offering a satellite feature of the software that can be used in your office. If their software solution is integrated with the Internet, you may be able to access it online.

No matter what you end up doing, having an EMR ready in place will allow you to transfer information quickly and efficiently.

In fact, when choosing a medical EMR, consider the reporting capabilities and features that will allow you to work with a medical billing company. There are plenty of EMR solutions out there that are designed to make medical billing easy, whether you do the medical billing in-house or you hire the work out to a medical billing company.

Physical Therapy Documentation: Revenue Trending Mechanisms and Their Impact on Your Practice Revenue

Physical Therapy Documentation: Revenue Trending Mechanisms and Their Impact on Your Practice Revenue

Medical documentation and billing is an integrated process, in which minor inefficiencies can cause a ripple effect in the way revenue is collected. Billing in particular, may be an area of concern. 

The smallest mistake on an insurance claim can lead to a delay in payment, time wasted by the biller while researching the mistake and re-submitting the claim, and potentially the loss of that revenue altogether. Nitin Chhoda teaches you how to resolve this, and grow your practice in the process.

physical therapy documentation revenueRevenue assurance is a growing financial and telecommunications field that looks at the devil in the details; inefficiencies that may seem small can cause a ripple effect in the way revenue is collected.

For a very large physical therapy documentation of a business, having a revenue assurance team makes some sense.

Determining Inefficiencies

Usually, the staff working on their jobs does not see inefficiencies or productivity leaks. A revenue assurance team or staff member can take the time to find the problems and can take a wide-angle view when looking for solutions.

In physical therapy practices, finding those revenue leaks is a very new task. Typically, it is up to physical therapy documentation and management staff to identify where revenue is lost and to recommend or require adjustments from the staff.

However, without a medical EMR or other physical therapy documentation software, it can be almost impossible to even identify the problem, let alone work toward a solution.

Revenue Assurance Mechanisms for Medical Billing

It is probably obvious that one of the departments where revenue leaks occur most frequently is within the billing department.

Medical billing and physical therapy documentation is especially prone to inefficiencies, because the smallest mistake on an insurance claim will lead to a delay in payment, time wasted by the biller while researching the mistake and re-submitting the claim, and potentially the loss of that revenue altogether.

Physical therapy documentation software is specifically designed to make it easier for medical coding and billing professionals to avoid mistakes. Because the information is entered directly by clinicians, the notes and weighted procedures can be standardized. Every time a clinician adds something to an EMR, they can choose a line of text that they have entered before.

For medical billing staff, this kind of consistency can improve claim acceptance rates significantly. If the coder knows what to expect, they can simply select the same codes repeatedly. Billers can identify what kinds of claims each insurance company accepts and where problems occur. The process can be streamlined and made more successful with physical therapy documentation software.

Focus on Productivity and Job Satisfaction

The job of the physical therapy documentation manager is complex. You must keep your eye on the big picture, looking for ways to improve the practice overall, but you also need to ensure that each staff member is getting some sense of fulfillment or satisfaction from the work they are doing.

Content, satisfied staff members are more productive and successful. The good news is that combining an effort to improve physical therapy documentation staff satisfaction with improved productivity can be incredibly successful.

physical therapy documentation impactImprove Staff Performance

Especially with the addition of physical therapy documentation software, the staff can be given the opportunity to make their jobs better for themselves, while improving their performance for patients and for the practice.

Revenue trending mechanisms that are put into place can feel insidious if implemented improperly. Nobody wants to be told they’re not doing a good enough job and that they are being forced to adjust by using new software.

But if the process is framed in the right way, with the right intentions, everyone can benefit from the new physical therapy documentation system.

Physical Therapy Billing — Behind the Curtains: The World of Insurance Companies and Payers

Physical Therapy Billing — Behind the Curtains: The World of Insurance Companies and Payers

For a private practice, the world of insurance companies and payers (Medicare and private payers) is a complex and intimidating one.

Nitin Chhoda explains the differences between government and non-government payers to help you better understand the ‘insurance scenario’ so you can make a better decision about the payers you’d like to get enrolled with.

physical therapy billing insuranceThe list of payers of a physical therapy billing in a practice can be long and complex.

Government programs, private insurance companies, auto liability insurance, and workers’ compensation programs all pay for physical therapy services and rehabilitation.

Even within private health insurance companies, physical therapy billing is incredibly complex.

Insurance companies have the power to impose very specific limitations on services provided. Each type of insurance provider will have specific requirements for enrollment and treatment.

Private Insurance Companies

Private insurance companies that cover the costs of physical therapy billing and treatment include automobile liability insurance, workers’ compensation insurance providers, and health insurance companies. Workers’ compensation systems are usually tied into the public system, and there are public providers of workers’ compensation insurance.

However, there are also private companies that work similarly to private health and liability insurance companies.

For physical therapy billing purposes, these companies will expect Current Procedural Terminology (CPT) codes in the Physical Medicine section. These codes help to standardize physical therapy billing as well as other health care services billing for particular procedures and treatments.

Payment policies can be different from company to company. Most physical therapy billing staff will already know that the only way to get claims approved is to follow the policy of each company to the letter.

Any minor mistake can be cause for rejection or denial of a claim. In particular, physical therapy treatments are often limited in number of visits or to a maximum dollar amount each year.

Other Physical Therapy Services

Physical therapy may also be lumped together with other rehabilitative services, making the pool of covered treatment even smaller if the patient is seeing other specialists, including speech-language pathology, occupational therapy, and even chiropractic work.

Physical therapy billing and practices must contract with individual health care insurance companies to determine the payment levels for service. For liability and workers’ compensation payment levels, there are often legal requirements set by each individual state.

Medicare and Other Government Programs 

physical therapy billing payersMedicare, Medicaid, and other government programs, such as county health coverage programs, operate separately and differently than private insurance, and each program has specific rules to follow for physical therapy billing.

In fact, for Medicare, the type and amount of payment is determined by where the physical therapy services are provided.

Different billing procedures are used for in-home physical therapy and treatment within a clinic. The services that apply to most physical therapy private practices are outpatient services. Medicare has an annual cap for physical therapy billing and services that is increased each year.

More Government Programs

Under Medicaid, physical therapy is considered an option service, but one that is still covered by most states. 39 states cover physical therapy even as an optional service, and in all states there are exceptions for “medically necessary” physical therapy and for inpatient hospital physical therapy.

Other governmental programs include services through the US Dept of Veterans Affairs and under the Individuals with Disabilities Act.

Physical therapy billing for all of these services can be overwhelming and confusing. There are many problems with the system, but physical therapy documentation software is making it a bit easier to handle the specifics of each program.

Physical Therapy Billing: Collecting Payment from Patients

Physical Therapy Billing: Collecting Payment from Patients

Physical therapy billing involves insurance claim submission and balance billing patients for outstanding dues.

Since patients are the most difficult payers, it’s critical for a practice to gather payment information during the patient intake process, and also to communicate with them about their insurance and balance billing possibilities.

This makes the patient aware of his / her responsibilities and helps the practice increase cash flow.

physical therapy billing of patientsIn an ideal world, every visit that patients made to the physical therapists would be seamless and payments would happen virtually, in the background.

Each time your physical therapy billing staff submits a claim, the hope is that it will be accepted.

Sadly, half the time, those claims are denied or rejected. And for many patients, this can mean that the onus of payment is on them.

Collecting payment is the hard part. When someone needs medical care, the last thing you want to do is demand they pay up for the services they’re getting. But the physical therapy billing system is set up the way it is and the best we can do is adjust and come up with smart ways to make the process less painful.

Pre-Visit Intake and Insurance Reviews

One way that some physical therapy billing departments are doing to make things easier is to work with patients up-front and determine what is covered before the patient has any bills due.

This process is not fool-proof, and it requires a lot of proactive work and planning on the part of the physical therapy billing department. But if a patient knows what to expect, payment is not as stressful and onerous.

With an integrated physical therapy billing EMR, as soon as the patient has entered their insurance and medical information, the staff can get to work finding out what the patient can expect to receive in terms of care.

Any co-payments or deductibles can be discussed up front. This means that the patient will be informed about their obligations and will not balk every time a payment is due.

Be Ready

Naturally, no system is flawless and there will still be situations where a patients insurance company rejects claims based on previous care that was not mentioned or other provisions that were not identified.

physical therapy billing collectionBut by taking the steps to avoid surprises, both the staff of physical therapy billing and the patients will find it easier to handle the payment process.

Payments from patients are more likely to be paid on time, and you can even collect payment up-front when the patient arrives rather than sending them a surprise bill in the mail at a later date.

Integrated EMR Solutions for Payment Processes

The only way that physical therapy billing staff can streamline the process in this way is if they have access to all the most relevant information. As soon as a patient has made a payment at reception, the billing staff should be able to pull up that information.

If a new appointment is made, information about who will pay should be calculated automatically.

On-site credit card processing should also be an option, for both one-time and recurring payments. Payments can be initiated from within an integrated physical therapy billing EMR.

Rather than put everyone through the stress of uncertainty and unexpected bills, a physical therapy EMR that makes physical therapy billing straightforward and simple can lift the burden from staff as well as patients.

Physical Therapy Billing: Patient Credit Card Payments 101

Physical Therapy Billing: Patient Credit Card Payments 101

On-site credit card processing is one of the best ways to collect payments from patients. With a credit card on file and signed permission from the patient, your practice can balance bill a patient without having to turn into a ‘payment collector’.

In this article, Nitin Chhoda reveals key insights to help improve payments from patients and convince them to give you permission for automated, credit card billing.

physical therapy billing 101The most modern and advanced physical therapy EMRs combine everything from patient intake to physical therapy billing in one system.

The benefits seem endless when you look at it from a physical therapy management perspective, but filling in the gaps for the rest of the staff is also very important.

There are many ways that patient interactions can be improved, including in the delicate arena of payment.

Benefits of On-Site Credit Card Processing

Although most physical therapy services are covered by insurance companies or government programs, a significant enough proportion of physical therapy billing payments will come directly from patients.

In fact, a good physical therapy billing and marketing strategy is to encourage patients who will be paying up-front for preventative services.

If you have at least some patients who are paying for their own services, you can predict certain levels of revenue that doesn’t come with the same delays and claims submissions.

These days, it is important to have on-site credit card processing as one payment option for physical therapy billing patients. Even if you are simply collecting credit card information in case of future incidental costs, the value of including integrated credit card payment processing into your EMR will be significant.

For co-payments or initial deductible payments, having recurring credit card processing capabilities will take a lot of time-consuming work out of collecting payment.

And for practices that incorporate up-front payment into their physical therapy billing practice, being able to charge the fees simply and efficiently with a stored credit card can make the entire process smoother and more comfortable for patients as well as staff.

Additionally, physical therapy billing staff should be able to see real-time updates to the payment status of patients, each time the credit card is charged.

Other Payment Precautions and Solutions

physical therapy billing processAccepting credit and debit cards on-site is just one part of the payment routines. Hopefully you are also equipped to accept cash and even checks.

Even though many people do not use checks anymore, there are still a surprising number of patients who will come through your practice hoping to pay by check.

Checks are a difficult form of payment for physical therapy billing to accept. The cost of a bounced check is not insignificant and the time it takes to re-bill is frustratingly slow.

But there are ways to accept checks safely. Now, you can integrate the Automated Clearinghouse (ACH) process into your EMR. You will be able to instantly determine whether or not a check is good.

Accepting checks may help you to increase the amount of up-front payments you can accept, making your practice more efficient at collecting physical therapy billing payments. Anything that improves your cash intake is a good investment.

Decreasing the Work of Physical Therapy Billing Staff

Another great investment is made each time you reduce the amount of work that physical therapy billing staff needs to manage. Up-front payments and on-site credit card processing make it possible for billers to be taken out of the equation for certain patients. This means they can spend more time and energy focusing on billing and collecting from insurance companies.

Page 1 of 3012345...102030...Last »