Healthcare lays the foundation of every economy, whether developed or developing. By offering a broad spectrum of medical services to people of all ages, the healthcare system focuses on maintaining and promoting disease or illness-free conditions. Its importance intensifies with the growing population, and the global pandemic has unquestionably proven this to bits!
However, any healthcare system is the sum of its units. Multiple operations keep the system running, including frontend activities (bookings, treatment record maintenance, etc.) and backend activities (medical data entry, bill generation, etc.)
Included among those backend activities, medical billing and coding are critical processes that sustain a healthcare system. Let’s get into the details of medical coding and billing and understand why outsourcing is beneficial for a medical business.
THE ROLE OF MEDICAL BILLING AND CODING IN THE HEALTHCARE SYSTEM
Medical facilities cannot operate without funding. They need persistent support from insurance companies and other healthcare sponsors.
Nevertheless, funding brings in documentation, records, policies, claims, and other similar attachments that aren’t easy to manage. Medical billing and medical coding come as the “ray of hope” here.
Coders and billers work behind the scenes to review documentation, translate it into universal codes, and submit claims to insurance companies. They read, interpret, record, and track medical information, maintain patient safety, and strong attention to detail.
LET’S LOOK AT SOME OF THE WAYS MEDICAL BILLING AND CODING ARE ESSENTIAL TO MODERN HEALTHCARE
REGULATORY AND CONTRACTUAL COMPLIANCE
Patient data and information must be protected at any cost. Medical billing and coding help in achieving this by following strict guidelines and regulations of the Health Insurance Portability and Accountability Act (HIPAA). The privacy and administrative rules of HIPAA apply to all healthcare providers who transmit electronic health information.
Billers and coders make sure that compliance is deeply integrated into all the healthcare operations and practices.
PATIENT CARE
The job of a medical coder is to review medical documentation and convert patient data or other medical information– diagnosis, treatments, procedure –into a universal, alphanumeric code. These codes act as the jargon between physicians, medical centers, insurance companies, and other health agencies.
A medical biller, on the other hand, a medical biller uses this code to create and submit reimbursement claims.
Though both coding and billing differ on certain grounds, their goal is similar i.e. reimbursing healthcare providers for patient services in a quick and hassle-free manner.
ENSURE PAYMENT FLOW
Every business yearns for smooth operations – be it related to cash flow, revenue, sales, or billing. In healthcare, medical billing and coding facilitate seamless operations by maintaining an uninterrupted revenue cycle.
Billers are responsible for critical activities, such as posting payments, adjusting bills, appealing submissions, managing collections, handling claims and other policies, etc. By maintaining and balancing all these activities, they promote smooth payment flow and business functioning.
KEY BENEFITS OF PARTNERING WITH MEDICAL BILLING AND CODING PROFESSIONAL
By delegating your coding and billing tasks to a skilled team, you can unlock a list of potential benefits.
CUT DOWN ON CODING AND BILLING ERRORS
Mistakes are possible in even the most professional settings, especially where a few resources are working on too many things at once. It’s not an indictment of your staff to suggest there could be a better approach to handling mistakes in billing or coding for diagnosis and treatment.
But, processing documents with several errors can result in claim rejection or denial. By outsourcing medical billing and coding, you can save yourselves from such situations.
The reason: a medical billing service provider is far more experienced and trained in working with codes, bills and data enrichment than your in-house team. Even if they commit some minor mistakes, they have QAs to identify the issue and advanced error-fixing techniques to resolve it. Resultantly, the number of rejected/denied claims due to billing mistakes will start minimizing and reimbursements on future claims will start maximizing.
SAFEGUARD PATIENT DATA
As a healthcare institution operator, you probably know the significance of patient data. You must also know how hackers are always looking for sensitive information. Therefore, keeping patient data safe at all times is highly crucial.
An adept medical billing and coding company ensures the same with proven processes, compliances, and security regulations. Most service providers have HIPAA-compliant and 100% secure medical billing processes to safeguard against any hacking attempts, so you can be relaxed and concentrate on other tasks.
UPGRADE CASH FLOW AND REVENUE
Outsourcing can considerably help you in saving costs as you no longer have to invest in additional medical billing and coding related expenses, including:
- Office supplies
- Furniture/infrastructure
- Postage and stationery
- Software purchase and maintenance
- Hiring costs
- Training sessions
- Clearinghouse fees
- Bonuses and other compensations
- Reimbursement charges on claims
When clubbed together, all these costs can be overburdening. Outsourcing medical coding and billing can help you cut that expense down significantly. Thus, by handing over this task to experts, you not only get access to top-grade services but save money, increase revenue, and facilitate smooth cash flow.
Please note, the savings can be even bigger for companies who have massive amounts of coding and billing tasks.
REDIRECT YOUR FOCUS ON PATIENTS
This is yet another critical advantage of outsourcing medical billing and medical coding to a third-party service provider.
If your team is busy handling billing issues, patient care will ultimately suffer. Plus, your team will be physically and mentally strained. It makes good business sense to hire a service provider for this particular business function and invest your time into quality patient care.
ESTABLISH BILLING COMPLIANCE
The healthcare industry undergoes diverse changes now and then. It can either be a minor change in billing or a major one in claims; either way, you have to stay updated and follow the latest protocols to establish billing compliance.
Tracking all the changes on your own and keeping up with them can consume a major chunk of your time while hindering your routine activities. This is where hiring a medical billing service provider proves to be of great assistance. They keep an eye on the latest changes in claim policies and other regulations and configure your operations accordingly.
Therefore outsourcing medical billing not only keeps you updated with industry standards but gives you the time to carry out critical medical assignments.
AMPLIFY PATIENT SATISFACTION
Who doesn’t want to keep their patients satisfied and happy? As a matter of fact, the majority of medical practitioners are urged to provide exceptional service to their patients.
However, doing it all at once, i.e., prescribing treatments/medicines, fulfilling customer demands, managing prescriptions, or booking appointments, can tangle up the entire process. Moreover, a good deal of patients struggle with finance and billing issues; not being able to resolve them due to an overburdened schedule can lead to dissatisfaction.
Save yourselves from unhappy patients by handing over the cumbersome task of medical billing and coding to experts. When your patients have all their billing-related queries resolved without any interruption, they are bound to be pleased. In addition to this, you will leave your staff with more time, thus boosting their efficiency and productivity.
WHAT OTHER TASKS DO MEDICAL BILLERS AND CODERS PERFORM?
Though the responsibilities and duties of medical billers & coders vary according to the client’s requirements, their most common tasks include:
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KEEPING DATA UPDATED AND ORGANIZED VIA DATA CLEANSING
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REVIEWING MEDICAL DATA AND RECORDS ON A REGULAR BASIS
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HELPING PATIENTS GET INSURANCE REIMBURSEMENT BY PROCESSING CLINICAL CODES
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PERFORMING MEDICAL DATA ENTRY BY INPUTTING RECORDS IN A PROPER FORMAT FOR MEDICAL DATABASES AND REGISTRIES
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TRACKING PATIENT OUTCOMES FOR QUALITY ASSESSMENT
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MAINTAINING COMPREHENSIVE ELECTRONIC RECORDS FOR HEALTHCARE PROFESSIONALS TO ANALYZE OR RETRIEVE DATA AS AND WHEN NEEDED
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FOLLOWING GUIDELINES AND REGULATIONS UNDER HIPAA
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ENSURING CONFIDENTIALITY AND SAFETY OF PATIENTS’ DATA
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VERIFYING INFORMATION IS CODED ACCURATELY BY REVIEWING PATIENT’S MEDICAL RECORDS FOR ANY PRE-EXISTING CONDITIONS OR PREVIOUS TREATMENTS
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KEEPING IN TOUCH WITH THE PAYERS
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SUBMITTING NECESSARY INFORMATION AND DOCUMENTS FOR CLAIM REIMBURSEMENT
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TRANSFERRING CLAIMS
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COLLABORATING BETWEEN THE HEALTHCARE FACILITY AND INSURANCE COMPANIES
Medical billing and coding are critical for streamlining your healthcare business processes and functions. Be it tracking data, transferring claims, contacting insurance companies, or maintaining a record of patients’ data, all such procedures require systematic handling.
Medical billers and coders employ state-of-the-art techniques, skills, and expertise to improve the effectiveness of your medical processes and facilitate patient satisfaction.
Ok, So Medical Billing And Medical Coding Sound Notable. How Do I Get Started?
It’s simple. Analyze your business requirements and brief medical billing and coding experts about your needs. From examining your medical data records and understanding your patients’ demands to crafting a distinctive plan, professionals can help you resolve your billing and coding needs while saving your time, efforts, and money.
Also Read: 4 THINGS TO CONSIDER WHILE CHOOSING MEDICAL BILLING SOFTWARE
