Medical Billing Services
Medical billing services handle the back-end tasks that ensure a healthcare practice receives payment for the services it provides. This includes coding, claim scrubbing, denied-claim management and other post-submission follow-up. Medical billers must also understand anatomy and pathophysiology in order to translate physician notes and operative reports into medical codes that reflect the actual procedures performed.
What is a monthly billing summary?
To minimize days in A/R, a good medical billing service Embed Partners strives to achieve a high first-pass claims rate. A first-pass claims rate is the percentage of submitted claims that make it past the clearinghouse and onto the payers’ processing systems for reimbursement. Medical billers who code clean claims and scrub them for errors, as well as manage rejected claims effectively, typically have higher FPARs.
The front-end medical billing process starts with staff capturing patient data during an office visit. Whether it’s via a standard registration form or at the point of service, it’s critical that front-office staff maintain accuracy with insurance plan information and verification of coverage. This data can then be used to determine the patient’s financial responsibility, such as a copay, coinsurance or deductible.
Ideally, the medical billing company you choose can offer a clear pricing structure without extra fees for setup, implementation or clearinghouse costs. It’s also helpful to find out if the medical billing service you’re considering has a flexible contract period that allows you to cancel without penalty should performance not meet your expectations. Lastly, look for a medical billing provider that offers a full, transparent view into the work of its billing team through its PMS, so you can see real-time progress on your claims.