Delivering quality service to patients at lesser costs

The reforms in the health care sector would essentially mean that physicians have to deliver quality service at lower costs. This is inevitable since doctors and hospitals can be penalized for negligence if they end up giving the wrong treatment due to increased work pressure and in order to meet the break-even point. As 45 million uninsured around the country are going to be covered under the reforms by the year 2014, it would become difficult to manage time and provide quality care at the same time.

The healthcare reform bill would essentially mean that health care providers would drown in work. The major issue here is not just dealing with the patients but also with the insurance companies and other necessities such as medical billing, coding, denial management and accounts receivables. When you want to concentrate on patient care then dealing with these auxiliary functions yourself may be taxing on you.

The perfect solution would be to hire professionals for the coding, billing and other functions such as accounts receivables to a team of experts who are not only professionals but are also experienced. It would not be pragmatic to hire a single person or an office assistant to perform these functions since it would not ensure quality in face of increased medical billing requirements.


The best way out is to hire people who are well trained in handling specialty such as yours and keep abreast of all the changes in the billing and coding. Such professionals can conduct quality checks and audits along with prioritization so that you receive the full value for the services that you have been rendered. They can also provide credentialing with new payers and handle all payer queries and get your claims paid.

All the above factors combined would mean that you do not face reduced revenues due to such other essential jobs. This would greatly relieve you of the burden of issues not directly related to your core job responsibilities. As we move towards a world where insurance companies are reining and getting insurance would be compulsory for everyone, it makes sense to hire experts who can assist you in doing your job in a smoother and efficient manner.

Medical Billers and Coders would like to be available for your requirements, thus they have together and are categorized as per specialty, experience, software known and locality. They can be easily found on www.medicalbillersandcoders.com, the largest consortium of billers across 50 states.

Browse All: Texas Medical Billing, Medical Billing California

Better revenue cycle management for physicians with skilled Billers and Coders

Accurate revenue cycle management essentially means that you get paid in a timely manner and the account receivables balance is zero when the cycle is completed. However, this type of management could become cumbersome for physicians since it is not their primary occupation and the recent health care reforms would mean more patients and work pressure. Therefore it becomes imperative that you have a system in place whereby you can delegate this job to professionals and concentrate on your practice.

Gathering of data is one of the crucial steps in revenue cycle management and the process starts when the patient calls your office for an appointment. With a busy schedule which may get busier by the day, it would not be a surprise if you are unable to verify the eligibility of the patient by checking with the insurance company.

the best way to ensure that you enhance the efficiency of your revenue cycle is using the correct and updated CPT, HCPCS, and ICD codes. This can be easily accomplished by hiring top notch coders who can deliver in a timely manner. Sometimes many physicians end up holding their charge slips for a complete day which can cause a delay in the billing process. Moreover, if you hire staff that does not have in-depth knowledge of the Medical Terminology or do not follow CCI edits and LMRP standards or have the correct coding exposure, it could jeopardize your collections for that month.

There are some basic steps in achieving better revenue cycle management including proper data gathering, automation (E-statements, e-prescribing, e-labs and accommodating electronic Remittance Advice instead of opting for EOBs), and professional billing and coding staff. This is the best way to achieve a zero accounts receivable balance. Therefore hiring office assistance with limited knowledge or expertise in this field can lead to problems. Moreover if these billers had no support to verify if there billing processes are accurate, that could lead to high denial rates or RAC audits. The best way to ensure that your revenue cycle management is a smooth and efficient process is to hire medical billers and coders who are experienced and have trained and up-to-date knowledge peers who they can consult in times of doubt.

Evaluate the services of the largest consortium of Medical Billers and Coders across all 50 States, for more information please refer to www.medicalbillersandcoders.com.

Medical Billing | Medical Billing New York | Ohio Medical Billing

Improving Quality And Revenue In Face Of Healthcare Reforms

The recent healthcare reforms proposed by the white house may affect the revenue as well as the quality of the service provided by physicians in the United States. According to a recent survey by Thomson Reuters, almost two-third of doctors in the US fear that health care reforms proposed by Mr. Obama might flood their offices which in turn would mean reduced individual attention to patients. Simply put, doctors would end up working more for lesser remuneration.


The survey also reveals that almost 68% of doctors think that the quality of service would drop because of the reforms. However, repealing the bill would also mean that more than 100 million people under the age of 65 would not be able to get health insurance because of a pre-existing condition. Nevertheless, the repeal of this bill is likely to fail in the senate. This effectively means that doctors would have to find a solution for plugging the gap between demand and supply of health care services.


2,958 doctors were surveyed by Thomson Reuters and physician services company HCPlexus in various states and of different specialties. When asked about how they were going to handle the newly insured, more than half of them said they would have to delegate the work to an assistant or a nurse. Although this may ease the pressure on doctors, it is just a make-shift solution for a change that looms large and can take place in as less as four years.


Electronic medical records might help according to 39% of doctors who were surveyed. Moreover, delegating administrative work can also be a solution. For instance, all billing and coding can be taken care of by highly trained professionals resulting in better time management and increased revenue.


The health care reform may be a radical change but still everyone would not be covered for everything and it would still be a good practice to send electronic files to a clearing house for determining eligibility. This can save time because it would reduce the amount of claims which are denied. Providing the patients with an electronic version of the bill and E-statements instead of mailing a paper bill would further cut costs by as much as 12 to 15%.


Some resident doctors would find themselves busier than before and since Federal law does not place any limit on the working hours of residents, it would be inevitable that they would spend more and more hours treating patients who are newly insured. Although the Accreditation Council for Graduate Medical Education (ACGME) has limited the work hours of residents to 80 hours, many residents work more and report less for fear of losing accreditation. This can be advantageous for doctors who would rely on nurses, residents and assistants to catch-up with the increasing demand for health care services.


There is no quick-fix solution to this since we cannot “import” doctors from other countries and the number of doctors and nurses cannot increase to a level in such a short period of time where they would be able to meet the demands. However, since Medicare is responsible for funding a majority of residency programs, there is a possibility that the recent bottleneck in such funding can be solved in the years to come which would result in recruitment and training of new residents. Moreover, there has been a growth of around 4% in residency slots from 1998-2004 which is the result of funding from a large number of teaching hospitals.


Some branches of medicine such as radiology and internal medicine do not require long working hours and can cope with increased volume of work. However, most of the branches would struggle to cope with the increased work pressure if a pragmatic solution is not developed before the reforms take place.


The biggest advantage a doctor or a health care provider can have are good medical billers and coders who can ensure quality even when meeting deadlines. This will make the process smoother for the physician as well as relieve him or her of work pressure. Now looking for Medical Billing Specialists locally and specialized in your specialty could be more taxing. In these trying times Medical Billers and Coders from every state, city and specialty have come together and are available to physicians at no cost at www.medicalbillersandcoders.com

Medical Billing Florida | Medical Billing California | Texas Medical Billing

Improving Quality And Revenue In Face Of Healthcare Reforms

Insurance fraud networks affecting Florida healthcare, Physicians turn to Medicalbillersandcoders.com for ethical and knowledgeable billers

WILMINGTON, Delaware, June 6, 2011 - The level at which healthcare insurance fraud operates in Florida has shocked the National Health Care Anti-Fraud Association and The Department of Financial Services, a division of Insurance Fraud, that investigates frauds for all types of insurance. The intensity with which the frauds are planned has alarmed the investigators and given them enough reason to investigate just about any clinic’s claims. 

• Physicians in Florida have paid Medicare beneficiaries to sign papers for the treatment that was not administered and use their Medicare numbers to bill Medicare
• Physicians support up-coding and un-bundling mostly for expensive drug infusion treatments for blood disorders
• Falsify medical records to show severe symptoms
• Hire specialized billing companies to bill Medicare
• Bill for deceased  doctor
• Bill for doctor not available at PoS to Medicare

Browse All: Medical Billing Florida

A consequence for physicians with such dubious intentions of course has been a sentence of ten (10) years and financial penalty depending on the level of fraud.

National Health Care Anti-Fraud Association estimates that nearly $51 billion that is approximately 3% of the healthcare industry’s expenditure in the United States is due to fraudulent activities. However, it is difficult to gauge the extent of fraud but it is estimated that annually $115 billion is drained out of the system.

Shocking it is, but medical fraud is highly prevalent in Florida; physicians gain financially and most patients feel they are not affected as insurance takes care of the expenses even if it is fraudulent. Unfortunately they do not realize that because of such practices insurance companies hike premiums that increase the cost of healthcare.

There is also a certain section of physicians who believe in billing only for the services provided and at appropriate cost ethically, but these physicians are unaware of the billing and coding practices. Such physician practices are dependent on billers and coders who may or may not fully understand the implications of incorrect or fraudulent billing. 

Incorrect or fraudulent practices over a period of time can land a physician’s practice under the scanner of Recovery Audit Contractor (RACs). Suspicious claims are submitted to the “special investigative units”, or SIUs, for further investigation. These units generally comprise experienced claims adjusters with special training in investigating fraudulent claims. These investigators are experts in cracking patterns of fraudulent claims, and look for evidence of falsification of any kind.

RAC reviews the last three years of provider claims with the help of proprietary software to identify potential payment errors in duplicate payments, mistakes of fiscal intermediaries', medical necessity, and coding.

Unintentional errors in billing and coding should not make you liable to these audits and hamper the credibility of your practice. Experts at Medicalbillersandcoders.com have been investigating these audits closely in Florida and have found that the main reason for Insurance Fraud allegations on a clinic is when the administration is handled by novices or non-certified billers. The negligence and lack of a forum to discuss issues such as unbundling, using more expensive codes, uncertainty in the use of modifiers, and adding referrals appropriately can easily be sorted out with a network of knowledgeable billers.

Medicalbillersandcoders.com, the largest consortium of Medical Billers and Coders is looking to combat ignorance and fix insurance fraud indicators, though the observations started from Florida but its awareness and solutions are being implemented across 50 states where the consortium extends its membership. Physicians currently being assisted by Medicalbillersandcoders.com are also appreciating the efforts of the association to educate and train billers against unintentional fraud.

About Medicalbillersandcoders.com
http://www.medicalbillersandcoders.com/about-us.aspx
Medicalbillersandcoders.com is the largest Consortium of Medical Billers and Coders, come together to service providers with their specialized needs across End to End Revenue Cycle Management, Medical Coding and Denial and Resubmission Management. With a presence across all 50 states and having expert resource servicing all specialties, this consortium is all set to revolutionize the process of locating Medical Billers and Coders.

Contact: 
Prerna Gupta, Media Relations
108 West, 13th street,
Wilmington, DE 19801

Tel : 888-357-3226
Email : info@medicalbillersandcoders.com 
http://www.medicalbillersandcoders.com/

Improving quality and revenue in face of healthcare reforms

The recent healthcare reforms proposed by the white house may affect the revenue as well as the quality of the service provided by physicians in the United States. According to a recent survey by Thomson Reuters, almost two-third of doctors in the US fears that health care reforms proposed by Mr. Obama might flood their offices which in turn would mean reduced individual attention to patients. Simply put, doctors would end up working more for lesser remuneration.

The survey also reveals that almost 68% of doctors think that the quality of service would drop because of the reforms. However, repealing the bill would also mean that more than 100 million people under the age of 65 would not be able to get health insurance because of a pre-existing condition. Nevertheless, the repeal of this bill is likely to fail in the senate. This effectively means that doctors would have to find a solution for plugging the gap between demand and supply of health care services.

2,958 doctors were surveyed by Thomson Reuters and physician services company HCPlexus in various states and of different specialties. When asked about how they were going to handle the newly insured, more than half of them said they would have to delegate the work to an assistant or a nurse. Although this may ease the pressure on doctors, it is just a make-shift solution for a change that looms large and can take place in as less as four years.

Electronic medical records might help according to 39% of doctors who were surveyed. Moreover, delegating administrative work can also be a solution. For instance, all billing and coding can be taken care of by highly trained professionals resulting in better time management and increased revenue.

The health care reform may be a radical change but still everyone would not be covered for everything and it would still be a good practice to send electronic files to a clearing house for determining eligibility. This can save time because it would reduce the amount of claims which are denied. Providing the patients with an electronic version of the bill and E-statements instead of mailing a paper bill would further cut costs by as much as 12 to 15%.

Browse all: New Jersey Medical Billing

Some resident doctors would find themselves busier than before and since Federal law does not place any limit on the working hours of residents, it would be inevitable that they would spend more and more hours treating patients who are newly insured. Although the Accreditation Council for Graduate Medical Education (ACGME) has limited the work hours of residents to 80 hours, many residents work more and report less for fear of losing accreditation. This can be advantageous for doctors who would rely on nurses, residents and assistants to catch-up with the increasing demand for health care services.

There is no quick-fix solution to this since we cannot "import" doctors from other countries and the number of doctors and nurses cannot increase to a level in such a short period of time where they would be able to meet the demands. However, since Medicare is responsible for funding a majority of residency programs, there is a possibility that the recent bottleneck in such funding can be solved in the years to come which would result in recruitment and training of new residents. Moreover, there has been a growth of around 4% in residency slots from 1998-2004 which is the result of funding from a large number of teaching hospitals.

Some branches of medicine such as radiology and internal medicine do not require long working hours and can cope with increased volume of work. However, most of the branches would struggle to cope with the increased work pressure if a pragmatic solution is not developed before the reforms take place.

Browse all: Washington Medical Billing

The biggest advantage a doctor or a health care provider can have are good medical billers and coders who can ensure quality even when meeting deadlines. This will make the process smoother for the physician as well as relieve him or her of work pressure. For instance you can get in touch with medical billers and coders in your area and your specialty at no cost at www.medicalbillersandcoders.com

How to Get Medical Billing Specialists for Free

Nowadays, with the increase in demand for medical billing services many people are entering the medical billing and coding business to offer their services and seek a rewarding career in healthcare. But not every biller is right for your practice, the job of finding the right medical biller for practices can be a difficult task and the cost involved can be quiet high. 

You can evaluate your options with the consortium Medicalbillersandcoders.com with its reach in all the fifty states of the United States . This association has categorized Medical Billers by number of years of experience, specialty, software and location. These expert billers have specially come together to help you:

1. Save Time: The first thing a biller can help you out is to save time. These billers have come together to shorten the time you spend in selecting them. One of the key benefits of hiring our billers from Medicalbillersandcoders.com is quick turnaround time. As a matter of fact it has become the habit of these billers to surpass their turnaround time by streamlining their methods and increasing their efficiency.
   
2. Increase Your Reimbursement: The medical billers and coders from Medicalbillersandcoders.com have a proven track record of increasing clients reimbursements. They are updated about the usage of ICD-9 as well as CPT codes and assure correct data entry by assisting in the collection of proper patient demographics. Their orientation to detail is outstanding owing to their billing experience of many years; they even recognize problems and resolve them independently.
   
3. Claims Set-up: Medical billing specialists of Medicalbillersandcoders.com administer strict quality measures. Manual check as well as random quality audit with the usage of statistical data is carried out to ensure hundred percent clean claims submission during the first time. They submit claims to clearing houses in order to ensure 100 % accuracy. They even cater to paper based claims and gradually help practices set up electronic submissions, reducing submission time to the same day.
   
4. HIPAA Compliance: Understanding HIPAA rules and regulations and how it applies to the providers' office, patients, government agencies, insurance carriers as well as billing policies is of top priority for our medical billers. They are legally responsible and assist physicians to surpass guidelines and secure their data.
   
5. Providers' Control over Billing: Providers may ask if they have control over their billing. Their worries are being put to rest since they always have total control over their billing. Checks as well EOBs are sent directly to the providers' offices and at the same time having a 24/7 access to the status of their claims. Specifically printed reports are provided to physicians weekly and monthly to keep them updated financially.

All these factors make our medical billing specialists the preferred choice in the industry. This consortium is a welcome step for the physicians since they can locate medical billers and coders within their city or state with experience in varying specialties and knowledge of software. And the process of matching the right resource to the right physician office, costs nothing. Yes, you heard it right. This consortium can help you to find the best medical billers and coders in the entire United States for free. 

You can simply visit the website, find the appropriate Medical Biller in your area and specialty, then dial the toll free number of the consortium or fill out a form asking for certain requirements. And get connected to the biller of your choice, either in your office, home-based or from a professional medical billing service. 

Browse all: Medical Billing Florida, Medical Billing Houston, Medical Billing California, Arizona Medical Billing, Medical Billing San Diego, Indiana Medical Billing

Top Seven Questions to Ask Before You Hire Medical Billing Specialists

You may think that hiring the services of a medical billing specialist will be like adding extra costs to your practice. But actually, hiring the services of a medical billing specialist can be considered as one of the smartest moves on your part in terms expanding your business.

Think about the ways you can be benefitted by them. Your already overworked staff won't have to spend a large amount of their time at the copy machine because a majority of the records can be handled online, with the use of secure and encrypted technology.

Medical billing specialists will ensure that the claims are properly coded and submitted in time. Your staff doesnt have to face any interruptions with patients queries as those will be handled by these specialists. More over their style of developing Patient Statement barely leaves scope for queries.

But one can refer to a few things before hiring medical billing specialists. The top most questions to ask before hiring a medical billing specialist may include:

1. Qualifications and Certifications: The most important requirement in terms of hiring a medical billing specialist is perhaps his/her qualification. Medical billing certifications are a necessary yardstick to determine whether a medical biller is qualified to take up the job. CPC, CPC-H, CCS-P, CCS, RCC, and OTR are some of the exams which can get a biller approved for Medical billing processes.
   
2. Experience: Medical billers nowadays possess experience in a number of specialties. Before hiring a particular biller, ask if he/she has experience in your particular specialty, has understanding of applicable coding subtleties and questioning them about their style of payer follow up can be a good idea, most payers these days are keen on IVR communication, with which Billers must be familiar. Besides, they should also be able to come up with resolutions in case of claim rejection.
   
3. Location: Medical billers and coders can be contacted from far and wide, in this day and age of electronic claim submission, physician offices also prefer home-based professionals. But some practices prefer local billers as they believe that local billers are more aware of the billing regulations of the state. But wherever they are located make sure that you don't have to compromise on quality.
   
4. HIPAA Compliance: Compliance to HIPAA regulations should be of top priority in order to ensure safety of PHI (Patient Health Information). Most medical billers claim to have adequate knowledge without really knowing the consequence of violation of HIPAA. So before hiring a medical biller , a clinic must verify the seriousness of the candidate towards information handling and avoid any leakage of crucial information.
   
5. Willing to learn your process: Your medical billing specialist should be open to learn your style of operations. A medical billing specialist should be able to explain the various steps involved in medical billing as well as explain what steps they can take to meet your specific requirements. Hesitant Billers who avoid making concrete promises may create trouble for you in the long run, it is best to avoid them.
   
6. Payer exposure: Denial rates and reasons vary amongst different payers. Careful scrutiny of the contract is necessary to understand the implications of various terms, rates as well as conditions given in the agreement thus saving you from some untoward surprises which you may have to face later on. Your Biller must be aware of the fee schedules and payer contracts for your specific specialty, they could help you improve your collections tremendously.
   
7. Nature of Reporting: Being aware of the reporting pattern of your biller, may be a good idea. In general, reports are usually generated on a monthly basis but you can request them to develop special reports for your special needs. Financial Reports are the main tool to judge a billers performance, these reports can help you to enhance your productivity as well as fix problems.
   

These criteria are an important way to determine the authenticity of the concerned medical billing specialist which every physician or practice must ask before hiring . Now hiring genuine billers will not be a problem for anymore. The largest consortium of Medical Billers and Coders - medicalbillersandcoders.com can help you to select the biller of your choice.

Stretched from Anchorage in Alaska to Honolulu in Hawaii and from Port Orford, Oregon in the west to Boston, Massachusetts in the east, this consortium is the ultimate representation of hundreds of skilled billers with experience in different specialties and updated about the latest technology.

Thus making it the one stop solution for all your medical billing specialist requirements as they have in-house billers, home-based billers and Medical Billing company all under the same group. You can choose as per your need.

Author:   Medicalbillersandcoders.com is the largest consortium of Medical Billers and Coders in the United States. We offer Medical Billing, medical billing and coding services, Medical Billers and Coders, Michigan Medical Billing, Medical Billing San Diego, Maryland Medical Billing

Medical Billing - 10 Blunders to avoid

Since the past few years, medical practices have seen stagnancy or declining medical reimbursements especially with the continuous rise in practice costs. Most practices are unable to understand the core reasons for dipping revenues and increasing denials.

Expert medical billers and Coders have recently come together to find out the top 10 blunders that physician offices are making which results in denials. The most disappointing problem is that they are unaware of these mistakes and commit them regularly without any amendment.

The most common mistakes that a medical billing office can make are elaborated below :

1. Piling on Old Coding Books : some of the physician offices still utilize old coding books as reference material but it is not advisable. With each passing year, new CPT, HCPS as well as ICD-9 coding books should replace the older versions; if at all the office is still interested in coding with the help of books.
   
   Most of the practices refer to codes that are available electronically, already built into their software. Codes are easily searchable and more resolutions are available on special coding software like Encoder Pro.
   
   
2. Blaming poor performance of Payers: The relationship between insurance payers and providers is a sensitive process of the reimbursement process. Inability of Medical billers and Coders to do their part of the bargain in time and blaming Payers of stringent regulations, can sometimes make the rate of denial go higher.
   
   At the end of the day, medical billers and coders must recognize that sinking reimbursements as well as increasing write-offs affect their practice. It would be their initiative to improve the quality of claim to get paid better.
   
   
3. Assuming the Patient is still under the same Insurance Plan: Presumption can be a big reason for claim rejection, front office staff cannot be taking it for granted that a patient is still under the same insurance plan. It is the tendency of patients to change their insurance policies. So, the billing office should confirm every single time if the patient has any new information to add to his demographic information thus saving thousands of dollars from refiling and rejection.
   
   More importantly, physicians must ensure that their front office is not overworked to check this crucial information.
   
   
4. Not Measuring Key Performance: Not closely monitoring key performance is a major mistake committed by physician offices. A professional practice flow knows that keeping track of Medical Billing performance is critical Financial Reporting or tracking key performance indicators has always been undermined which also includes days in accounts receivables outstanding, trial balance on accounts that has gone aged and other such important indicators.
   
   
5. Engaging Wrong People: Healthcare jobs seem to be the most stable growth opportunity and thus lots of people hope to get into Medical Billing and Coding jobs, the result medical billing and coding courses are enrolling many students without making any potential. It is important to put stress on finding the right medical billing personnel with appropriate experience and willingness to grow. Even for the experienced Billers checking references for new recruits, verifying credentials and conducting a relevant test before deciding to hire can be a good idea. Physicians must also consider bringing the administration team together and setting good processes right in the beginning.
   
   
6. Not Verifying Patient Benefits: As a patient’s plan changes all the time, their deductibles as well as co-pays also changes. The preauthorization of patient benefits though time consuming should be not be scraped and it is recommended that the physician office should develop a policy as well establish a time frame in order to verify the process of patient benefits.
   
   
7. Never Fully Utilizing a Practice Management System: The way systems are developed these days, most physician offices don’t utilize them even 40% of its capacity, especially if an untrained user is operating it. Exploring the potentials of your system helps you take maximum benefit of your investment in Practice Management Systems.
   
   Besides old, outdated management software can pose a lot of problems and engage a lot of cost in maintenance and up-gradation. So it is the duty of every physician office to have adequate knowledge, develop one’s own skills and at the same time reach out to other users in learning from them.
   
   
8. Missing on Patients Vital Information: Sometimes medical billing offices make the mistake of not taking down patient’s vital information such as his/her telephone number, preferred insurance and other benefits. It is necessary to note down all of these into an encounter form since this information is bound to play a crucial role in the collections process later on.
   
   Missing out getting a sign on some critical forms for information release and Advanced Beneficiary Notice can later impede efforts on denial management or even appeals.
   
   
9. Failure in automating: Automation is necessary for maintaining profitability in this competitive market. With the usage of electronic health records, it has become easy to overlook the applications of various technologies. Medical Billing can be simplified physician offices work more with fewer employees, but for which a strong base in the technology is required.
   
   Keeping up with new demands can happen only with new technology to simply and automate routine tasks. Failure in automating definitely impedes practice growth.
   
   
10. Failure in Prioritizing their Work: With the rate of work increasing all the more, prioritizing work can become quite critical for billing offices. They have to manage a number of responsibilities such as payment posting, appealing denials, A/R receivables and so on but they will have to know how to prioritize their limited time.

Addressing many such issues is the expert billers and coders of medicalbillersandcoders.com - the large consortium of medical billers and coders. These billers have come together to be trained and grow with the healthcare fraternity, they help physicians across 50 states avoid blunders as mentioned above. With hundreds of billers available in the every specialty and having different software experience,

Medicalbillersandcoders.com is here to streamline physician offices and improve collection unconditionally.

To counter all these common errors, these billers take a number of steps to ensure efficient billing including keeping themselves updated with the latest CPT codes as well as billing software, help in maintaining an amicable relationship with payers, automation and so forth. The biggest positive of these billers is that they are willing to grow and accept change as it comes. They bring along with themselves the expertise and help your current staff accommodate the best industry practices.

This consortium was created by specialists of the healthcare industry for the convenience of the healthcare providers keeping in mind the best criteria to shortlist the best medical biller or coder in your area.

Browse all: Medical Billing Florida, Medical Billing Houston, Medical Billing California, Medical Billing New York, Medical Billing San Diego, Ohio Medical Billing

How to Find the Best Medical Billing Specialist in your area

One may ask why practices require medical billing specialists. A crucial reason might be that taking up the services of a medical biller or a coder may lower overhead costs and expenses but definitely will help the physician to collect more revenues. Physicians across all states are constantly facing difficulties in insurance coding and payment reimbursement in terms of their insurance claims. For them optimizing reimbursement is accompanied with a lot of complexity since there is flux in the medical billing rules and regulations frequently.

Engaging the services of professional medical billers will help the providers to effectively steer their clinics operations towards other functions which can help them grow their practices. Hiring professional services will give the providers an opportunity to manage and organize their business in areas that require critical attention including better patient care, healthcare documentation needs, marketing their own practice and increasing the number of new patients they can retain.

Now, before hiring medical billers, a particular practice should take into considerations a few aspects such as:

1. Experience of Billing Specialists- A thorough and deep understanding of medical billing in terms of multiple specialties is a necessityfor any biller to have a holistic view of the insurance industry. Their experience in handling various processes such as insurance eligibility and benefit verification, charge capture, payment posting, claims transmissions, denial management and follow up on account receivables gives you the confidence to rely on them. [Prerna Gupta] The number of years of experience definitely counts when complex billing situations arise.
   
   
2. Medical Billing Software experience- Before hiring a medical billing service, providers should consider that they are appropriately trained in the usage of medical billing software used in your clinic such as Medisoft, Altapoint, NueMD or any other software. An important characteristic to look for in a medical billing software is that it should easily and effectively process both insurance as well as patient billing and should have the capacity to handle different types of claims. These may include secondary or third party claims and workman’s compensation.
   
   
3. Flexibility- The term 'flexibility' can apply not only to the software but to the billing specialist as they must be willing to learn more. This will be demonstrated by his/her ability to process different types of insurance claims and at the same time handling a number of medical billing situations while dealing with insurance companies and patient queries.
   
   
4. Certification- Certification does not mean everything for a Medical Biller but most Billers who undergo certification process are confident about their knowledge. They also develop the best industry practices and apply them for your clinic. The most popular certification organization, AAPC - American Academy of Professional Coders holds CPC exams across the United States to determine the authenticity of billing and coding professionals. The American Health Information Management Association (AHIMA) also provides most of the certifications and advocates the correct application of CPT, HCPCS procedure and supply codes and ICD-9-CM diagnosis codes. Having certified personnel on board guarantees error free billing for you.
   
   
5. Their Network- It is important for Medical Billers and coders to network with as many professionals as possible specializing in different specialties and billing software. If a particular biller is not confident about the reason for denial or other nuances of the specialty, they could refer their doubts to their peers and seek solutions faster. These Billers are also willing to grow and advance as professionals.
   
   
6. References- Reference can help medical billers to go a long way towards building a healthy client base. This can help providers to trust a medical billing specialist to handle their billing requirements for them. Along with the list of the credentials, a crisp resume, references from former employers or seniors can help the provider to make sure that the medical biller is experienced and trustworthy.

These aspects can be taken into consideration only if you find appropriate candidates to interview, the question arising here is where to locate them? It is best to take the help of medical billing consortium which show the billers willingness to learn, network and grow. Medicalbillersandcoders.com is one such consortium with its reach in all the fifty states of the United States and at the same time provides trained medical billers and coders to physician groups without a fee.

Going to Medicalbillersandcoders.com is a welcome step because it can help physicians to locate Medical Billers and Coders in their city, state, specialty and having experience in their software. Medicalbillersandcoders.com is one of the easiest ways to find the best medical billing specialist, just log on to the website and match your requirement with the available profiles. It is a consortium having hundreds of billers and coders for your preference. They are a specialized lot having experience almost all the specialties including cardiology, dental, dermatology and general surgery.

This consortium was created by specialists of the healthcare industry for the convenience of the healthcare providers keeping in mind the best criteria to shortlist the best medical biller or coder in your area.

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California Physicians worried about increasing denials turn to Medicalbillersandcoders.com for assistance

WILMINGTON, Delaware, June 1, 2011 - Denial rates of California’s biggest payers being as high as PacifiCare -- 39.6 percent, Cigna -- 32.7 percent, HealthNet -- 30 percent, Kaiser Permanente -- 28.3 percent, Blue Cross -- 27.9 percent, Aetna -- 6.4 percent, the Denial rates in California are witnessed to be on an all time high, as reported by California Department of Managed Care. From 2002 through June 30, 2009, the six insurers rejected 45.7 million claims -- 22 percent of all claims.

Contradicting general expectation, the rate of denial by private players is lesser than the Government program, the Medicare program since its inception acknowledged the existence of regional variations in medical practice reimbursements and has sought to accommodate these differences in adjudicating claims but California denial rates seem to be standing out.

But according to the AMA‘s National Health Insurer Report Card annual, Medicare denied medical claims at nearly double the average for private insurers: Medicare denied 6.85% of claims. The highest private insurance denier across US was Aetna @ 6.8%, followed by Anthem Blue Cross @ 3.44, with an average denial rate of medical claims by private insurers of 3.88%

Even after these denial ratios dropped one year, the observed trend suggested that the denial rates are manipulated to suit the requirement of that fiscal year. Our Medical Billing and Coding specialists suggest the use of industry best practices to accomplish steady income and reduction in denial rates.

Medical Billers and coders from our consortium having a base in California have had a close look at the trends in denial management in the past decade, they have managed to discover a pattern or particular reasons for every payer in the state denying claims.

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These billers discovered that Carriers differed in how they treated incomplete claims, if information required by the payer to process the claim was missing, the carrier could: Return the claim to the provider, this action of the carrier is like the claim had never been submitted Develop the claim (delay adjudication and try to obtain the required information by contacting the provider) Deny the claim, the provider then had to resubmit the claim or go through the appeal process to obtain payment for this service Denial Management is getting tougher even for specialists as the Carriers even differed in how they interpreted certain national coverage; most specialists are confused as the charge raised by them for different carriers is being treated differently.

A decade long study has also been brought out by expert billers and coders from Medicalbillersandcoders.com, this study reveals resolutions and check list formats of how to bill for the top five deniers in the state of California in order to have maximum payout for physicians and minimum denials.

Some of the specialist practices even noticed a denial of 7% of claims submitted in the current fiscal year, with the reimbursements freezing physicians groups are definitely looking to manage profitability better. They are seriously looking for specialists who can handle their denials specifically. Medicalbillersandcoders.com members in California are highly specialized in working denials and depending upon the age of the claims and reasons of denial can even provide assurance of collections.

About Medicalbillersandcoders.com
http://www.medicalbillersandcoders.com/about-us.aspx
Medicalbillersandcoders.com is the largest Consortium of Medical Billers and Coders, come together to service providers with their specialized needs across End to End Revenue Cycle Management, Medical Coding and Denial and Resubmission Management. With a presence across all 50 states and having expert resource servicing all specialties, this consortium is all set to revolutionize the process of locating Medical Billers and Coders.

Contact:
Prerna Gupta, Media Relations
108 West, 13th street,
Wilmington, DE 19801
Tel : 888-357-3226
Email : info@medicalbillersandcoders.com
http://www.medicalbillersandcoders.com/