Successful Medical Billing in Tampa, FL
Ensuring being reimbursed on time is quite a challenge for hospitals and healthcare facilities across the US. As a medical facility you would be familiar with this as well as how a lot of this burden falls on the shoulders of your in-house medical billing team.
Once patients submit their insurance details at the front desk, payments are considered settled. But this is far from what actually goes behind the scenes. From submitting claims to receiving the final payment is one long process that your medical billing team takes care of.
When managing such a complex and long-drawn system it helps to have your team follow a step by step method to ensure smooth functioning of the billing process. Here are 6 key steps your team can follow for effective functioning of the medical billing process.
- Registration of Patients
Patient check-in or registration is the first step involved in the medical billing process. Front-desk professionals collect the patient’s basic information like age, gender, address, phone number, and email address. In addition, they also require the patient’s insurance details, such as the insurance payer and policy number. These details need to be entered accurately and updated regularly during each visit of the patient to the medical center. This ensures there is no delay in the claim and the process is not long drawn out.
- Verification of Insurance
Insurance policies are subject to change. It is possible that the policy’s scope of coverage has changed due to some reason, expired, or needs authorization information. These reasons can impact the benefits. This is why your in-house medical billing team should double-check the patient’s insurance details before consultation. This will ensure there are no errors and there is no hassle while processing for reimbursement. An error-free claims form can speed up the process so there are no delays or denials.
- Medical Coding
As per the guidelines laid down by American Medical Association (AMA), all the patient’s information must be entered in correct alphanumeric codes so that the healthcare insurance payer can make an accurate assessment to pass the claim. The mandatory points required are:
- Reason for visit
- Diagnosis
- Treatment regimen recommended
- Address of the medical care center
Make sure your medical billing resource uses only standardized guidelines for describing a patient’s illness and symptoms.
- Claims Submission
After successfully collecting the patient’s data, the correctly filled claims form has to be submitted to the insurance payer for reimbursement. While all the insurance companies follow a standard procedure, some co-pays follow their own guidelines. Ensure your medical billing team does not miss this step of how and when to submit a claim to the dedicated insurance company.
- Claim Denial Management
Time limits are critical when it comes to the acceptance of claims. The insurance payer runs specific checks before the payment of the claim. While sometimes the claim gets fully paid, there are instances when it gets paid only in half or is denied. This happens for many reasons, such as the crossed time limit. You can resend the claim to recover the declined charges and generate complete revenue. Also, you can ask your team to compile a list of rejection issues to prevent future claim rejections.
- Collection of Payment
The insurance company decides to pay the claim amount after running all the checks and releases the payment via paper check or process the electronic fund transfer. The company also shares an Explanation of Benefits (EOB) summary. Also, the medical billing professionals are responsible for posting the payment entries in the EHR software to match the payment received.
GMB Can Help You Overcome Your Medical Billing Challenges
Medical specialists at Gables Medical Billing (GMB) services are skilled and experienced at managing insurance claims, denials, and running an effective medical billing process. They have expertise at handling delays and denials of claims by insurance companies and ensure corrective action is taken promptly.
When you partner with the GMB medical billing team in Tampa, FL you get the benefit of the finest medical billing services for your facility. For more details contact GMB or call 786-725-2120/855-469-1422 to speak to our billing experts.