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Posted on November 6, 2014 by · Leave a Comment
Filed under: Medical billing outsourcing  

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Medical Billing Outsourcing Services

There are quite a few things to consider if you are a medical provider looking to outsource your medical billing and coding processes. It may be hard to choose medical billing services since you will be handing the control over the essential aspects of your job or practice.

Overview Of Medical Billing Outsourcing Services

Outsourcing your medical billing work has its own advantages; it helps you to concentrate on your job since you do not need to waste your time on medical billing works. However, when choosing a medical billing outsourcing service, you need to choose one that specifically serves your needs. Otherwise, it will be a big loss of money and time. Well, given below are few tips that will help you to choose the correct medical billing and coding services.

In order to maintain a successful relationship between physicians and their billing services, communication and transparency are the key factors. Try to make sure that the medical billing outsourcing services that you are opting for offering good communication policies, which will help you to communicate about your requirements with the service provider. Some of the questions that you need to consider are,

  • How they work insurance denials
  • Type of reports they run
  • Ensuring method of communication, i.e. whether it is through email, phone or chat

Medical Billing Outsourcing Services

Another thing that you need to consider while going for medical billing outsourcing is whether the medical billing service that you are choosing is making any changes to the medical billing codes like CPT, HCPS, and ICD-9 without your permission. If it does so, it is not recommended to continue with that specific service provider. An efficient medical billing service provider will find the errors that you have made in the medical billing codes and correct it. However, when doing so, first they need to consult you. This will help to prevent the liability issues in the future.

Using a medical billing service that files claims through an internet-based management system is one of the easy ways to feel a sense of retaining control and managing transition issues. Moreover, go for a service that bills on an emergency fee, since it is the most favored method of billing. It will be easier to judge your costs each month if you are going for a set dollar amount per claim.

These are the things that you need to look for when opting for medical billing outsourcing.

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We write quite a bit about the benefits of outsourcing your medical billing to a highly-qualified third party medical billing service. But we‘«÷re not the only ones; if you search on Google, you‘«÷ll find quite a number of articles on the benefits of outsourcing.

Here are a few of the greatest hits, which we think you‘«÷ll find useful.

As early as 1999, the American College of Physicians-American Society of Internal Medicine wrote about comparing inhouse and outsourced medical billing, citing the example of one doctor in Pennsylvania who began outsourcing the practice’s billing. Since then, he said, he was getting more money‘«Ųcollections had increased more than 30%‘«Ųand getting paid faster. ‘«£Those are the benefits of outsourcing billing operations that third-party billing companies like to tout: higher collection rates and fewer staff headaches,‘«ō the author states.

The article goes on to explain that the solution isn‘«÷t so simple for every practice, and that ‘«£mom and pop‘«ō medical billing services provide mixed results. We couldn‘«÷t agree more, and have written about that in several blog posts. That‘«÷s why we argue that a nationwide, multi-branch medical billing service is the best bet for improved revenue.

Next, medical billing software resource?ŠSoftware Advice published a popular article?Šon its blog,?ŠThe Profitable Practice. This article actually included a study done by the site, which came up with the following results comparing annual costs for both approaches:

In-House

Outsourced
Billing department costs $118,000 $4,000
Software and hardware costs $7,500 $500
Direct claim processing costs $3,600 $122,500
Software and hardware costs $5,500 $2,000
% of billings collected 60% 70%
Collections $1,370,900 $1,623,000
Collections costs $129,100 $127,000
Collections, net of costs $1,241,800 $1,496,000

 

Eye-opening, isn‘«÷t it? To think that you could reduce your collections costs and still collect more on an annual basis‘«Ųthat additional $254,000 to the bottom line is nice to have, in our opinion. Of course, that is once again predicated on the idea that you see an increase in your collections, which requires a medical billing service with experience and trained staff.

The article also provided some recommendations on factors that would spur a provider to consider outsourcing their billing, including:

- Your billing process is inefficient.

- You have high staff turnover.

- You’re not tech savvy.

- You’re a new provider.

- You have different priorities.

All good points‘«Ųwe agree that these are good reasons to consider outsourcing your medical billing.

Most recently, we have seen two articles published by Med City News on why outsourced medical billing may be the best option for many practices. In the first article, the author points out that ‘«£More than 10% of debts for a majority of providers go over four months and are unfortunately written off as bad debts. Medical billing services, on the other hand, are much feistier in their attempt to recover debts, often turning out to be successful in cases where in-house billing teams tend to fail. Therefore, providers facing outstanding debts for longer times have much to gain by outsourcing their billing to a renowned medical billing company to experience higher revenues and much shorter billing cycles.‘«ō

In the second article, the same author points out that ‘«£Your medical billing company will be contractually bound to perform some services, such as appealing denials which will eventually result in shorter billing cycles‘«™

‘«£Outsourcing medical billing services also results in a much lower claim rejection rate such that a medical practice can expect between 5% to 15% increase in the amount they are able to collect by opting for a billing service.‘«ō

We strongly agree with these statements, as we have seen these types of improvements repeatedly with our own clients. But we also agree with the idea above that it‘«÷s important to evaluate whether outsourcing your medical billing is right for your practice; only you can make that decision.

If you‘«÷d like to learn more about choosing the right medical billing service for your practice, download our free white paper, When and to How Select the Right Medical Billing Service. It‘«÷s full of checklists you can use to determine whether outsourcing your medical billing is right for you, and how to find the medical billing service that will provide the results you want.

You can also call us today at 800-966-9270 to talk with one of our expert practice revenue consultants, and they‘«÷ll be happy to discuss your needs and how we can help bring more to your bottom line.

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Physicians Practice, a site I admire and read frequently, recently posted an article entitled ‘«£

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When and How to Select the Right Medical Billing Service

All too often, we see practices choosing their medical billing service without really qualifying them. Since selecting a medical billing service isn‘«÷t a frequent event, the staff member tasked with finding this key partner may have little experience, and no checklists or other qualifying tactics to use.

We believe using a checklist is the best way to insure that you ask all the questions you need to in order to make the right choice, so we‘«÷d like to offer an abbreviated version of the checklists you’ll find?Šin our new white paper, When and How to Select the Right Medical Billing Service. You can find complete information on the selection process and the full checklists in this white paper, but to get you started, here are some of the key questions:

 

Checklist of Questions for Potential Medical Billing Services

(Note that some questions should be asked directly and others based on observation)

Background

  • How?Šmany years has your company been in the industry?
  • How?Šmany years‘«÷ experience does management have in the industry?
  • Gross amount?Šof billings?
  • Number?Šof clients by specialty?
  • Number?Šof claims processed annually?
  • Can you provide a list of?Šcurrent and past client references?

Performance

  • What?Šis your clients‘«÷ average Days in Receivables Outstanding (DRO)?
  • What?Šis your clients‘«÷ average A/R over 120 days percentage?
  • What?Šis your clients‘«÷ average net collection rate?
  • Has?Šyour clients‘«÷ cash flow improved or declined over the last 90 days? If it ?Š?Š?Š?Š has declined, why?
  • What?Šis your process for continuous improvement?

Customer Service

  • Does your?Šcompany provide an Account Manager? If so, what level are they and what?Šauthority do they have? How many clients will they be handling?
  • What?Šis your process for reporting and escalating problems?
  • Do you?Šhave a customer-service process or guidelines you can share?
  • Does?Šthe medical billing service present itself as a vendor or as a strategic?Špartner to the practice? (Observation)

Compliance

  • Do you have a HIPAA-compliant record retention and?Šstorage policy?
  • Do?Šyou provide HIPAA training to employees?
  • Do?Šyou have procedures in place to prevent the hiring or retention of?Šexcluded employees?
  • Do?Šyou have a plan in place for ICD-10 implementation?

Capability/Scalability

  • Are your employees certified or credentialed? If so,?Šhow many and what are their certifications?
  • Do you conduct background?Šchecks on new and current employees?
  • How do you measure employee?Šproductivity?
  • Do you have ongoing training for?Šyour employees?
  • Do you perform?Šquality-assurance reviews of your employees‘«÷ work?
  • Will you be hiring additional?Šemployees to handle our billing? If so, what percentage of your current?Šstaff will this be?

Reporting/Transparency

  • Do you provide management reports on a?Šmonthly basis? What are they?
  • Can you produce?Šindividualized, unique reports?
  • Can you provide reports like?Šthese on a regular basis:
    • Accounts?ŠReceivable ‘«Ű aged by either date of entry or date of service
    • Practice?ŠAnalysis ‘«Űoverall reporting of the practice charges and?Šreceivables
    • Transaction?ŠReport ‘«Ű general report of payments, charges and adjustments
    • Claims Report?Š‘«Ű to show claims submitted for a reporting period

Pricing

  • How do you charge for your services?
    • Percent of gross?Šcollections?
    • Fee per claim?
    • Other?
    • How do you avoid the?Šdisadvantages associated with your model, such as reduced incentive to?Špursue small claims when you‘«÷re charging a percentage?
  • Are there costs?Šassociated with startup? Adding new providers?

Procedures

  • Is there a policy and procedure in?Šplace for bad debt or small balance write-offs?
  • How are bad-debt?Šcollections handled?
  • How are accounts?Šreceivable from a previous billing company or in-house billing process handled?
  • Who has ownership of the?Šdata if the contract is terminated?

For a full discussion of these categories and their importance to your evaluation, and for the complete set of checklists including a list of questions to ask references, get our free white paper now.

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As a physician and owner of a medical billing service, I find there are a number of misconceptions about in-house medical billing among practice owners. Many providers have heard these fallacies from their predecessors and colleagues, and they have come to believe them. But they‘«÷re simply not true, and I‘«÷d like to address the top 10:

1.?Š?Š?Š?Š?Š?Š In-house medical billing costs less than third party medical billing. In order to compare the costs of in-house vs. outsourced medical billing, you must consider the complete actual costs. With internal medical billing, salary is typically only about 70-75% of your employee costs ‘«Ű when you figure in payroll taxes, FICA and insurance, the costs add up quickly. Costs to include in your calculations are:

  • Medical Billing Specialist’s Employee salary
  • Medical Billing Specialist’s Employee benefits
  • Worker’s compensation
  • FICA
  • Healthcare insurance
  • Vacation, sick leave, etc.
  • Performance bonus
  • Computer hardware purchase & maintenance
  • Software purchase & renewal

Plus, you need to consider the added paperwork cost of administering the employees, and training costs.

2.?Š?Š?Š?Š?Š?Š You have more control over your finances with in-house medical billing. Don‘«÷t mistake proximity for control. Just because you can walk down the hall and ask your billing team questions doesn‘«÷t mean that you have the control you need. It‘«÷s important to have industry-proven controls in place to insure that your revenue cycle management is performing as it should, and that you are not being underpaid by payers.

3.?Š?Š?Š?Š?Š?Š In terms of embezzlement and other security issues, it‘«÷s safer to have your medical billing in-house. Again, don‘«÷t mistake proximity for control. Many practices have found that an in-house biller or billing manager was embezzling because no one was checking on them. Reporting and following best practices are again key to protecting your cash flow and bottom line.

4. You have better reporting with in-house medical billing. You unfortunately cannot insure that you have better reporting with in-house medical billing unless the staff member preparing your reports understands the key performance indicators you need to track, and generates the reports reliably and accurately.

5. ‘«£The closer the better.‘«ō Many physicians feel that ‘«£out of sight, out of mind‘«ō applies to their medical billing‘«Ųnot true. Just because you can see your medical biller, that doesn‘«÷t insure that you are seeing the level of revenue cycle management your practice deserves.

6. ‘«£I know what I need best.‘«ō Physician, don‘«÷t diagnose thyself. Neither you nor I were trained in medical billing in medical school, and it is a very specific skill. It takes some time to learn and understand all the nuances, regulations and requirements, and that is not the best way to spend your highly valuable time.

7. In-house medical billing is faster and more reliable. The fact of the matter is that with in-house medical billing, you are limited to the availability and capabilities of your internal staff. When your medical billing specialists are sick or on vacation, you’re still paying them for not working. When you outsource your billing and take advantage of professional medical billing specialists, the overhead and paperwork is ours, not yours. And when your billing is handled internally, if you lose a core member of your team you can lose years of training and knowledge. With Medical-Billing.com, you are guaranteed complete redundancy so that there is continuity of business processes ‘«Ű which is a significant burden off your shoulders.

8. I have better control over denials and appeals with in-house medical billing. As I‘«÷ve mentioned, control is not a matter of proximity. Good management of your denials and appeals, as with other aspects of revenue cycle management, requires accurate reporting,?Š analysis and management‘«Ųabilities that you may not find internally.

9. ‘«£My staff will be fine with the ICD-10 transition.‘«ō This, frankly, is a big gamble.The transition to ICD-10 is going to require a good understanding of anatomy and good training to insure that coders and billers understand the new structure. In the meantime, you could be faced with delayed revenue as denials pile up.

10. Finally, I am frankly amazed at healthcare professionals handling medical billing themselves; it‘«÷s not part of clinical care‘«Ųwhy do it yourself? Focus on what you do best. When you face a clinical situation that requires a specialist, you refer the case. Treat your practice revenue the same way‘«Ųuse a specialist to insure the best possible care.

If you would like to take a good look at how your revenue cycle management could be improved by letting specialists handle it, contact us at Medical-Billing.com at 1-800-966-9270 or email sales@medical-billing.com.

Alex Tabibi, MD, is Executive Director of Business Development/Marketing for Medical-Billing.com, a nationwide medical billing service that provides revenue cycle management for more than 500 practices nationwide. Alex is a board certified physician and began his career as an oncologist. He earned his medical degree from the USC School of Medicine, where he graduated with Highest Distinction.

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How do you select the right medical billing service for your practice? Too often, the decision is made based on just a few criteria, such as a colleague‘«÷s recommendation or what you disliked about your previous billing service. This can result in a skewed view of the new billing service‘«÷s benefits.

That‘«÷s why we recommend a more analytical approach. As we have mentioned in previous posts, when considering an external medical billing service there are several criteria you should take into account:

  • Performance
  • Customer Service
  • Compliance
  • Reporting/Transparency
  • Technology
  • Capability/Scalability
  • Pricing

In this post, let‘«÷s look at Capability/Scability. For previous sections, see our blog posts on Performance, Customer Service, Compliance, Reporting/Transparency and Technology. We‘«÷ll discuss the remaining areas and how to evaluate them in future posts.

Capability/Scalability

Naturally, a key to selecting the right medical billing service is evaluating both the service‘«÷s capability, or qualifications, and its scalability. You want to make sure that the service is qualified to handle the type of billing you need, and that it has the capacity to handle your billing in a timely fashion.

Certifications/Training

You can ask for references from the medical billing service, and should, but another good way to assess the qualifications of the management and staff is to ask about certifications and ongoing training. There are two organizations that certify medical billing personnel:

Ask your medical billing service candidates how many of their personnel hold one of these certifications. Also, ask whether the service invests in continuing education for its staff members. It‘«÷s important for billers to stay up to date on changing requirements in the industry, and the organization should encourage this.

Scalability/Capacity

As mentioned earlier, there are varying sizes of medical billing services, as in any industry. While we all want to encourage new business growth, it‘«÷s important to insure that the billing service you sign on with has the capacity to accommodate your billing needs in a timely fashion. If the vendor is small or will need to add staff, you need to assess their ability to scale quickly and effectively. Ask for information regarding:

  • What is the current size of the?Šorganization? If they are adding staff to handle your billing, what?Špercentage growth will this be? Growth of more than 10-20% could mean?Šuntrained staff and lack of oversight.
  • How many office locations does the?Šgroup have currently, and is there capacity in these offices for ?Š?Š?Š?Š additional staff if needed?
  • Will the service use its own staff?Šwith oversight, or subcontractors?
  • Will the service outsource overseas??ŠIf so, has it done this before and is familiar with language, culture and?Štraining barriers?
  • How many claims does the vendor?Šprocess annually compared to the number your practice will require?
  • How many practices is the firm billing?Šfor currently? Has this number grown, stayed the same or shrunk over ?Š?Š?Š?Š the last year?
  • What specialties does it currently handle? Do they handle your specialty, and can they provide?Šreferences?

A particular medical billing service may have been right for your practice once, but you may have outgrown their capabilities. If so, you need to look for a medical billing service that offers the capabilities, technology and pricing your practice needs now.

That‘«÷s why you should consider Medical-Billing.com. With over 50 years of combined management experience and multiple locations around theUS, we are proud to deliver excellent results for our physician partners through a relentless focus on efficiency, technology, training and measurement of metrics.

Call Medical-Billing.com today at 1-800-966-9270 or email us: pr@medical-billing.com

Posted on July 25, 2012 by · Leave a Comment
Filed under: Medical billing outsourcing  

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Do you miss the good old days where you could treat the patient and get paid just like that minus the medical insurance claims hassles? Well folks, things have changed a lot for good or worse. The most modern medical billing system has created a lot of confusion and headache to the practitioners around the country. The evolution of the same has inflicted a state of panic around the medical industry. The present scenario is a little challenging, forcing the practitioners to work overnight clearing the billing and coding hassles. Here, I would like to stress the importance of medical billing outsourcing and the advantages offered by the same.

Medical billing outsourcing: reasons for outsourcing

Defining the limits of the billing system is not only complicated but literally impossible. Analyzing the patient demographics is one thing, coding the procedures is another chore. Not to mention, the charge entry process often drives us crazy. There are a bundle of procedures that need to be completed before the claim actually gets submitted. As such, any trivial mistake in anyone of the procedures will result in a total denial. Your only solution is medical billing outsourcing, which has made tremendous impact in the revenue management. The said method has numerous benefits and advantages. By medical billing outsourcing, I mean assigning your day to day office works to an external service provider so that they will finish the work before a period of time.

This will help you minimize the billing errors and help you achieve reimbursements faster. As such, the difficulty is reduced drastically. You can sit back, relax and treat your patients with ease while the medical billing companies work on their part. Medical billing outsourcing will eliminate the usual concerns of the physicians and make the practice stronger. If you just think about your previous experience with the manual data entry process, I am sure you will contract with a service provider right away. Such providers assist your staff in successfully completing the medical billing process. Medical billing outsourcing companies have state of the art technologies and experienced personals to asses, organize and double check the claim for errors. Apart from that, these companies deliver the result on time without delays.

Hope the above article titled ‘«ˇLatest improvement in medical billing outsourcing‘«÷ was educative and informative. Please give us your valuable feedbacks. Good day folks!

Posted on December 22, 2011 by · Leave a Comment
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Medical billing outsourcing has really become popular these days as healthcare providers fight to keep up with the emerging trends in the healthcare industry. Quite often, providers find themselves bumping into some issue with the insurance company, which might be due to a trifling error or a mismatching procedure code on the claim form that finally results in rejection of the forwarded claim. This has caused many physicians and healthcare facilities to look towards medical billing outsourcing as the better option for their various billing tasks.

Moreover, several medical billing companies have sprouted within the past few couple of years providing additional service and support to clients. The following are some of the services that billing companies provide.

Services that can be availed through medical billing outsourcing

The first and foremost thing that you can avail through medical billing outsourcing is efficient healthcare processing activities. This includes enhanced billing procedures ranging from patient demographic entry to AR follow-up and 24/7 customer support as well. Through medical billing outsourcing, you‘«÷ll be able to save about 40-50 % of your existing cost and expense. Moreover, you have rest assured that all your claims are being handled by professionals who see to it that all your claims are submitted as well as tracked in order to ensure proper payment of your claims in a timely manner.

Through medical billing outsourcing, you can also make use of various features and options like weekly production reports, patient scheduling, etc. which will help in keeping up with the progress achieved by your billing partner regarding insurance claims and patient bills.

Patient billing and invoicing is yet another important aspect which you can avail through medical billing outsourcing. In addition to that, several medical billing companies give you the benefit of updating EOBs (Explanation of Benefits) into the billing software on a daily basis. This will indeed help you a lot with finding details on all your processed claims. Based on your requirement, medical billing companies will help you perform tasks like Patient Entry, Charge Entry and Payment Posting in an efficient manner.

In all sense, I guess medical billing outsourcing is the best thing you can do for your practice. So, if your thinking about expanding your practice, you can go right ahead and outsource your billing tasks to a good medical billing company.

I guess that should be all the help you need with medical billing outsourcing. Thanks for reading and have a good day.

Posted on February 16, 2011 by · Leave a Comment
Filed under: Medical Billing, News  

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Medical billing outsourcing is becoming more prevalent in today’s society. What are some of the reasons behind the shift in the workforce locations? There are many advantages to the companies of any industry that can outsource their work. This is why the United States has seen an increase in the amount of outsourced work. The concept is not new; outsourcing has been a popular way of conducting business for quite some time.

Consider it an economic advantage. By moving positions away that can be handled at a lower cost somewhere else, resources are freed up here. Allocating a budget becomes more cost effective in departments that may otherwise have fallen short. For instance, medical billing outsourcing allows for reduction in computer and software costs that would be present if a company were to retain this task. The average computer needed to run these types of programs would be close to $1000. The software, though not costly in itself, often requires licenses for each user at about $100 for each user, sometimes more. Add in the cost of electricity for running the equipment, salary or wages for the worker, a space to have them work in ‘«Ű All these things add up to money that can be better spent on other needs of the business. Medical billing outsourcing provides the freedom to do this.

The field of medical billing has many regulatory restrictions that are applied due to consumer protection laws, the Fair Credit Reporting Act, and several other agency restrictions. By medical billing outsourcing, the burden is shifted from the hospital or medical office to the company that is supporting the outsourced. Again, this is an economic advantage, as there is no cost for the medical office to train a professional to learn and keep up with all the regulatory requirements of medical billing and collections.

The bottom line is that by using medical billing outsourcing, more energy and effort by medical staff can be spent on servicing the patient and providing an elevated level of care and concern. This will provide a better image of the medical facility and in turn, help to increase revenue and return business to that facility. It is a win for the medical offices and a win for the patients they serve.

Another economic advantage to medical billing outsourcing is that by sending the work elsewhere to be done, postage and phone costs are reduced significantly. For every dollar saved in administrative costs, that much more can be placed to things that will improve the business. It could be the purchase of new or advanced technologies, or perhaps the hiring of a specialized doctor. The possibilities are limitless.

Posted on November 22, 2010 by · Leave a Comment
Filed under: News  

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Medical Billing – Wading Through the Volumes Of Paperwork
In most medical practices, the biggest concern for proprietors is billing. For the small practice, billing consumes vast amounts of time better spent in the practice of medicine. In-house medical billing usually results in higher costs for salaries, benefits and pensions that decrease revenue. The answer to the problem is medical billing outsourcing to increase your income and production.

Medical Billing Outpouring – What To Look For
Many medical billers find this is a profitable source of income resulting in single owner or larger billing firms. Depending on the number of clients billing is done in a timely, efficient and cost-effective manner, three significant elements to keep in mind when searching for a medical billing outsourcing practice. The other prerequisite is experience in medical terminology and billing techniques. Medical billing outsourcing practices maintain state-of-the-art billing technology and stay current with changes to medical billing resulting from interface healthcare insurance industries. Medical billing practices should be well versed in various versions of wide ranges of healthcare insurance providers’ policies.

Costs For Medical Billing
Generally, medical billing practices base their costs to clients on the number of patients billed as well as specifications required by each medical practitioner. There are variations in medical billing such as those generated by primary care physicians and specialists as well as hospital care and diagnostic services. Thus, medical billing practices should have a strong background in the particular area of healthcare as well as the number of versions healthcare providers offer. These elements are generally part of the overall costs of outsourced medical billing practices.

Where To Find Outsourced Medical Billing Practices
In most cases, those in the medical field want the most experienced and reputable medical billers to manage their invoicing. In some instances, this might also include billing to medical vendors such as pharmacies, diagnosticians who perform services in-house or ambulance services for office to hospital transport in the event of emergencies. Medical billing is one of the fastest growing industries because of the huge volume of medical practices and increased hospital care. Outsourced medical billing practices can be found online or through the local medical associations. Medical associations offer a wide range of services that include assistance with finding a medical billing group.

Key Factors To Discuss Before Engaging A Medical Biller
Obviously, timely billing is essential to increase income and production. This is one factor that should be discussed before committing to a particular service. Initial billing data may be entered into an in-house computer system and then transmitted to the medical biller. Or, data may be downloaded by the medical biller on a daily basis with the use of an intranet module.

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