Why You Should Think About Using Outsourced Medical Billing

why outsourcing might be a good choice

Outsourcing for medical billing services can make a difference in how smoothly your organization runs and how satisfied your patients are with your practice or hospital. Once services are rendered, a certified medical coder translates the details of the patient’s record into the codes that insurance companies use to determine how much they will pay for the services provided. Prompt insurance payment is essential to ensure that your patient does not receive unnecessary statements displaying an unpaid balance, which can lead to confusion and upset your patient, which leads to more complications for you and your practice.

Why Your Practice Needs a Certified Medical Coder

A certified medical coder typically assists practices in navigating the multifaceted network of regulatory and legal health care requirements. Furthermore, certified coders ensure that proper payment is received for the services rendered.

To decrease the amount of time between services rendered and insurance payment, billing mistakes must be avoided. Certified medical billers are familiar with using the codes that adhere to the national standard (ICD-10). Accurate billing means fewer delays in payment, which is great for your practice and for the patient.

The Importance of Certification

In years past, a manager could supervise daily processes as well as perform procedure coding and billing: However, the continued changes in the healthcare industry have made this previous convenience nearly impossible. Today, in order to receive payment, ICD-10 requires greater specificity. In addition, insurance auditors are examining claims closer than ever before. When you hire and partner with certified medical coders, you know that these individuals are well-versed in the coding guidelines and requirements set forth by insurance companies. In addition, to remain certified, a medical coder must participate in ongoing continuing education: Thus, ensuring that they stay informed about regulatory and coding changes.

A certified medical coder will:

  • Target high-risk areas through continuous internal audits
  • Implement denial management strategies to identify the root cause of insurance denials
  • Ensure accurate reimbursement through coding accuracy and knowledge related to ICD-10 guidelines
  • Educate and train staff members concerning coding and regulatory changes
  • Improve clinical documentation, which frequently assists physicians in recognizing the complexity and severity of a patient’s condition

5 Characteristics of an Effective Certified Medical Coder

1. Detail-Oriented

Each insurer has its own requirements. For this reason, certified medical billers must be able to recognize these variations and code accordingly. This reduces the incidence of rejected claims, thus avoiding the frustration and delayed payment associated with an appeal.

2. Technical Skills

With all the changes that have been made in relation to medical billing, a certified coder must be able to bill and process claims electronically. In addition, the individual must be knowledgeable about running reports as well as monitoring and addressing insurance denials.

3. Interpersonal Skills

A certified coder must feel comfortable interacting with others: Forming positive relationships with insurance company representatives, practice management retailers, coworkers and patients. Building healthy relationships is an integral part of providing strong credentialing services.

4. Integrity

Maintaining integrity involves remaining compliant to regulatory and legal health care requirements. In addition, protecting each patient’s confidentiality is vital.

5. Analytical Skills

A medical coder must have the ability to review a chart and recognize all of the relevant codes denoting the clinical complexity, and severity of a patient’s health issue. In the event that the information available in a patient’s chart does not support his or her specific diagnosis, a certified medical coder will notice this inconsistency and work towards solving this problem by discussing it with you.

About Right Medical Billing

One way to ensure that the certified coder you choose has the qualifications you desire is to hire a specialist from one of your local, reputable medical billing outsourcing companies, such as Right Medical Billing. With more than 30 years of combined experience, RMB’s staff members have the knowledge, experience, skillset and dedication to provide you with the quality medical coding and billing you need. RMB takes the time to learn about your practice’s specific needs. Right Medical Billing offers much more than certified coding: We partner with our clients, providing training for staff members and patient billing support. Our ultimate goal is to improve your overall billing practices and insurance claim acceptance rate to increase your revenue.  If you wish to improve the workflow and revenue of your practice today, contact us to outsource medical billing and speak with one of your specialist to see how we can help you and your practice improve.

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