Medical billing refers to the process of surrendering insurance claims and looking into them with the intention of receiving payments for services offered by healthcare providers.
With the various complex forms of medical billing and coding, an expert biller can help in improving revenue performance for the health providers. Hence, it is advisable for medical professionals or clinics to outsource such complex areas to experienced medical billing companies or consultants.
Medical billing is an important step in settling health insurance claims for any healthcare institution. The following three areas of medical billing are worth outsourcing because of their complexities. Each of them offers its fair share of hurdles and challenges that require keenness of an expert medical billing specialists.
Termed as Federally Qualified Health Center (FQHC) Billing in full, it takes account of physicians’ services, along with those additional services carried out by a physician. Billable visits include face-to-face encounter between physicians and the patients.
FQHC billing covers the services rendered by Physician Assistants (PA), Nurse Practitioners (NP), Visiting Nurses (VN), Certified Nurse Midwife (CNM), Clinical Social Worker (CSW) and Clinical Psychologist (CP). FQHCs can help in executing billing for face-to-face, therapeutically essential visits provided by dentists, chiropractor, optometrist, or podiatrist.
As long as the medical services meet FQHC requirements, the service provided on the list of qualifying visits will guarantee payment. The complexity of FQHC billing is that all the furnished healthcare services must reflect the scope of practice of every state for the practitioner. Furthermore, it necessitates that all HCPCS codes must reveal the practical services furnished in the claim. As a result, many of these health centers opt to outsource their needs via FQHC billing services.
Surgery billing ensures that healthcare providers submit an accurate CPT-4 code, which clearly gives a comprehensive account of the surgery done for all the services furnished in the package. Professional billers can help you submit well-defined and accurate claims indicating the exact date of surgery.
Such vital measures take in the dates when the healthcare providers furnish the full global period, which may include surgical care only, postoperative care, or shared postoperative care. Surgery billing has complex processes because the surgery billing department must get in touch with the patients’ insurance company for the verification of their coverage details.
It also helps in obtaining any precertification or authorization for the services rendered by your surgeon. It becomes a challenge if your physician did not provide the billing office with accurate insurance information. Therefore, a dedicated billing company will always help to streamline such mistakes by contacting the patients and the physicians immediately.
When it comes to cardiology, the financial strength of the practice directly correlates to the timely settlements of insurance claims. Outsourcing cardiology billing services to a qualified billing company stands out as one of the vital decisions healthcare providers can make concerning their business practices.
Cardiology billing companies must have the necessary expertise for handling complex procedures offered by its processes and modifiers. Cardiology billing services come with many challenges compared to other specialties because of the sophisticated medical procedures.
The last few years have seen many changes to the billing and coding regulations resulting in fee cutbacks for cardiologists. Therefore, it is necessary to hire cardiology billing experts to carry out billing for cardiologists. They will provide flawless, undeniable billing and coding services to achieve maximum timely settlements for your medical claims and practices.
Outsourcing the above forms of medical billing and coding helps in translating healthcare services quickly into billing claims. In any healthcare facility, medical billers play the vital role of following up the claim to make sure that healthcare providers receive timely payment for their services.