The Good:

1. Efficiency: Billing software can significantly increase efficiency by automating repetitive tasks, such as data entry and invoice generation. This can save time and reduce the risk of human error.
2. Accuracy: Modern billing software is designed to be highly accurate, reducing the likelihood of billing errors that can lead to financial disputes or regulatory issues.
3. Cost Reduction: Using billing software can reduce the need for extensive manual labor, leading to cost savings in terms of employee salaries and operational expenses.
4. Data Security: Good billing software often includes robust security features to protect sensitive financial data from breaches and cyberattacks.
5. Analytics and Reporting: Many billing software solutions come with built-in analytics and reporting tools, allowing companies to gain insights into their financial performance and make data-driven decisions.

The Bad:

1. Cost of Implementation: Implementing billing software can be expensive, including the initial purchase cost, training, and potential customization to fit the company’s specific needs.
2. Learning Curve: Billing software can be complex, and employees may require training to use it effectively. This learning curve can lead to temporary disruptions in operations.
3. Dependency on Technology: Relying heavily on technology can be risky if there are system failures, technical glitches, or if the software becomes outdated.
4. Security Concerns: While billing software can enhance security, it can also be vulnerable to hacking and data breaches if not properly protected and maintained.
5. Lack of Customization: Some billing software may not fully meet a company’s unique requirements, necessitating additional development or workarounds.

Regarding the billing company’s usage of the software, it’s crucial for them to:

• Understand the Software: The billing company should have a thorough understanding of the software’s capabilities and limitations to maximize its benefits.
• Employee Training: Adequate training programs should be in place to ensure that employees are proficient in using the software efficiently and securely.
• Procedures and Compliance: The billing company must establish procedures that align with industry regulations and best practices to ensure compliance when using the software.
• Regular Updates: Keeping the software up to date is crucial for security and taking advantage of new features or improvements.
• Data Backup and Recovery: Robust backup and recovery procedures should be in place to protect against data loss.

In conclusion, while billing software offers numerous advantages, it’s essential for billing companies to carefully consider both the advantages and disadvantages and take steps to mitigate potential pitfalls. Proper education, training, and procedural safeguards are crucial for harnessing the full potential of technology in billing operations while minimizing risks. Fortunately, Merem Healthcare Solutions encompasses ways to mitigate both the bad and good in technology, so you don’t have to worry about anything related to your revenue cycle management operations.

The post Technology: The Good and The Bad appeared first on MEREM Health.

The motto for getting paid is to Ask Early and Ask Often for Payment.

The fact is, the further into the collections process you go, the less likely a patient is to pay in full. If your practice’s patient collection efforts only go as far as issuing statements and generating “bad debt” reports of accounts that are turned over to collections, it’s likely that less than 50% of those collection balances will be recovered.

If this describes your practice, an improved strategy for Patient “Pre-Collections” that is both aggressive and fair should be implemented. Revenue for services rendered is the lifeblood of any facility, and if patients need to foot 40% of the bill, you can’t afford to miss out.

• Discuss payment expectations when you discuss procedure and appointment setting. If unable to pay in full, collecting a nominal portion the day before or the day of may make it worth proceeding.

• Collect a portion of co-pays upfront from patients. This isn’t always possible in the case of many emergency room admissions, but it is for specialty services such as elective surgeries and ancillary procedures.

Point of Service Collections

Point of service collections is just as important as insurance collections. Missed co-pays can quickly add up to a significant revenue loss. In the long run, point of service collections helps to cut down on statement costs and patient AR.

In order to

Patient billing is a significant problem for patients and providers.

ensure patients understand their coverage and are aware of their responsibilities — and that you get paid. Develop a self-pay policy, communicate it clearly to both staff and patients, and self-pay collection will become an integral part of your practice workflow.

People are not aware of their deductibles for specific procedures but when the time comes, it’s often the front office staff that has to educate patients about their insurance and the agreed-upon patient responsibility. Oftentimes, patients who hold high deductible health plans and other aggressive patient cost-sharing models are unpleasantly surprised with they find our they are ultimately responsible for their surgery. Patients who need to pay out of pocket for some or all of their medical care are frustrated by difficulties understanding what’s covered and what they owe, the lack of options for payment plans, and the poor timing of bills and communication around the process.

Front office staff are intimidated to collect payments or have not perfected Point-of-service collections, the art of asking for payment.

collecting some or all of the co-pay upon admission or before services are rendered

For Example:

Don’t Ask: CAN you can pay today?

Ask: How WILL you pay today?

Make it easy for patients to pay. 9 times out of 10, patients say they want to be able to pay their medical bills online. Facilities and healthcare providers can help ease the burden for patients by setting up customized payment plans, using patients’ preferred payment methods — which helps ensure that bills will be paid.

We don’t just set up a payment framework and then walk away; we are committed to giving providers the analytics, technology infrastructure, clinical support, and other resources that increase their likelihood of success. We also try to understand and address their challenges; for example, knowing that cash flow is a big issue, we’ve worked to make billing cycles shorter and more predictable.

The post Principles of Improving Patient Procedure Collections appeared first on MEREM Health.

By utilizing an experienced team of medical billers and coders who are knowledgeable in various specialty medical codes and trends, you can rest assured that things are being handled properly behind the scenes while you and your medical team can take care of patients upfront.

Chances are what first brought you into the healthcare industry was wanting to help others. You wanted to make a difference in people’s lives and give them more quality years. However, as you started your own private medical practice, you probably saw it was filled practice management tasks leaving you with less time with patients and more time behind a desk dealing with insurance and other revenue cycle demands. 

Be More Proactive in Your Medical Billing and Coding

According to Healthcare Business & Technology, more than 80% of medical bills contain errors. Medical billing errors are the biggest reason for the disruption of cash flow in a physician practice. 

Fortunately, by making sure everyone on your team is on the same page when it comes to documentation (as well as having a strong medical billing and coding team), you can greatly reduce these errors so that cash flow in your medical practice continues to move in the right direction.

No Errors Allowed!

As you well know, most medical billing errors are due to:

• Incorrect patient information, which includes insurance provider information
• Duplicate billing
• Poor documentation
• Unclear claim numbers
• Wrong codes being used

However, by putting the proper training in place and outsourcing your medical billing and coding services, you can ensure that a majority of your claims will not be denied. 

When these medical billing and coding errors take place, claims come back denied. Resubmitting a fixed claim denial with the correct information can take weeks for review and approval on the other end. In addition, this puts a delay in not only payment from insurance but also slows down the payment received from the patient. 

Medical billing errors add up quickly. Before you know it, your medical practice is starting to lose money rather than gain. However, by utilizing an experienced team of specialized medical billers and coders who are knowledgeable in various medical codes and trends, you can rest assured that things are being handled properly behind the scenes while you and your medical team can take care of patients upfront. 

Give Your Patients the Experience They Deserve

Even during a normal health care checkup, a patient’s anxiety can be high. Therefore, having a warm welcome can make all the difference in starting the patient’s experience off on the right foot within your medical practice. 

Allow our team to handle the billing and coding services behind the scenes so that your front office staff, along with other members of your medical team, can focus on the patients walking through your door and providing them with the best experience possible! 

Remember, happy patients will not only return. The chances are high that they will bring friends! 

Discover how our team at MEREM Healthcare Solutions in Birmingham, AL, can help your medical practice avoid medical billing and coding errors. 

Merem Healthcare Solutions offers services for every step in a practice’s revenue cycle management. We can start from the beginning from credentialing and end with payment posting once an account has been satisfied. We offer a wide range of solutions which include auditing, billing, coding, consulting, credentialing, payment posting, practice management, and pre-collections training. Check us out on our website or feel free to call us to see how we can help run your practice like a well-oiled machine – (205) 329-7519.

The post Outsource to Avoid Medical Billing and Coding Errors! appeared first on MEREM Health.

Therefore, while we don’t want to take away from the amazing work of physicians, nurses, front desk employees, etc., our team at MEREM Healthcare Solutions also wants to make sure medical billers and coders receive the recognition they deserve for the critical role they play within the healthcare industry.

What Do Medical Billers and Coders Do?

While your patients might not see them during their visit to your medical practice, medical billers and coders are there every step of the way—from the initial examination to diagnostic tests to the overall treatment of the patient. Medical billers and coders are responsible for translating the entire patient visit into special ICD-10 codes for proper billing.

But, before you start thinking, “How hard can that be?” did you know there are more than 140,000 ICD-codes? And each ICD-10 code has its own purpose. For instance, there isn’t just one code for “pain.” Rather, there is one ICD-10 code for pain in the arm that is unspecified. Then, there is another code for low back pain, and so on and so forth.

Not only is it vital for these specific codes to be known, but it is also vital that they are used correctly, as one wrong code entry could cause a delay in billing and payment, which can hurt a medical practice’s profitability.

The Unsung Heroes – Off-Site or Outsourced Medical Billers and Coders

Although some medical practices try to utilize their front office staff to assist with the medical coding and billing of patients, this practice of sharing responsibilities is not as conducive for the profitability of the medical practice as outsourcing the billing and coding to a third party.

For example, a patient walks into your medical practice. Depending on your specialty, your patient might already be high-anxiety. When they walk in, the front desk person isn’t able to welcome them warmly because he or she is on hold with an insurance company. All the patient has done at this point, is walk into your practice, and everything is already off on the wrong foot.

However, if your medical practice outsourced your medical billing and coding, not only can you reduce your chances of errors when it comes to cash flow, you can also allow your front office staff and medical team to focus directly on the patient, which can both improve patient outcomes and patients reviews—which is a win-win!

Discover how our team at MEREM Healthcare Solutions in Birmingham, AL, can help your medical practice avoid medical billing and coding errors.

Merem Healthcare Solutions offers services for every step in a practice’s revenue cycle management. We can start from the beginning from credentialing and end with payment posting once an account has been satisfied. In addition to outsourced medical billing and coding, we offer a wide range of solutions which include auditing, consulting, credentialing, payment posting, practice management, and pre-collections training. Check out our website or feel free to call us at (205) 329-7519 to see how we can help run your practice like a well-oiled machine.

The post Don’t underestimate the integral role medical billers and coders play in the healthcare industry appeared first on MEREM Health.

How Do You Determine
The Best Fit For Your Practice?

Have you struggled with choosing an outsourced Medical Billing Company?  Is your medical practice overwhelmed with the paperwork of billing and coding?

If you have outsourced your revenue cycle management process, how did you know that the outsourced medical billing and coding services company you are working with was the right fit for your practice? 

With a reputable billing and coding service, physicians can stop focusing on billing issues and get to what’s important: the patient.

Outsourcing your medical billing and coding to a professional healthcare solution company is advantageous for a number of reasons. Understanding what to look for is essential when choosing a company to outsource your medical coding. 

Check out the list below provided by MEREM Healthcare Solutions for the top the things to consider before choosing the best medical billing and coding company for your practice.

Are you still unsure about outsourcing your medical billing and coding? If so, check out our latest article,

“Should You Outsource Your Medical Coding? Yes!”

How Much Is the Medical Billing and Coding Company Willing to Do for You?

Looking for the best fit?  The best medical billing and coding companies perform above the industry average. The most basic medical billing company will provide:

• claim submission,
• carrier follow up,
• payment posting and processing,
• patient invoicing,
• and collections.

You’ll want to seek out and choose a medical billing and coding company that delivers more than the basics. Ask about their specific performance metrics, including net collection ratio, days outstanding, denial/rejection rate and the average number of days in accounts receivable (AR).

For many practices to even consider outsourcing, patient follow-up is key. If a patient fails to pay, you should expect that the billing company you are outsourcing these matters to will pursue that debt, right? Unfortunately, some will not.

Also, does the billing company provide frequent and detailed analytics and reporting to help your practice recognize what they can do to grow? Or do they just provide a bank statement once a month?

Any company that you are considering to partner with should be transparent about the services that they will deliver in order to help you determine which is the best fit for your practice. Choose a company that goes above and beyond the basic credentials. You also want to find an outsourced solution working within your specialty field of medicine.

Choose Experience And Specialty Expertise

When choosing a medical billing company, experience matters. After all, experience can ensure a smooth, problem-free onboarding process.

The number of years a company has been in business matters, but it’s not the only consideration. You also want to look for a company that has worked for a sizable number of years in your particular specialty. This ensures that they fully understand your field and have more intimate knowledge of the specific requirements for medical coding, documentation, compliance, etc. related to your specialty—whether it’s Advanced Imaging and Radiology, Obstetrics and Gynecology, Orthopedics and Sports Medicine, or Gastroenterology.

Perhaps they have only been open for three years, but those three years were spent learning the specific, highly-detailed ins and outs of your specialty. Ask your prospective medical billing companies the following questions before you commit.

• How many years of experience do you have working in your area of expertise and in our area of medicine?
• How many clients in that specialty do you currently have?
• What size practices are you used to managing?

The answers to these questions will help you to weed out the companies who aren’t a good fit and can help ease your mind about partnering with an outsourced healthcare solution that is ready and able to seamlessly take on your practice’s medical billing and coding.

Discuss Technology… The Good and Bad

Technological advances have made for some fancy billing software. Find out what type of software the billing company is using. Does the company understand the full usage of the software? What kind of software education and procedures are in place for their employees?

Your practice wants to ensure there is not a violation of HIPAA privacy rules. A loss of data would most likely shut down your medical practice. Be sure your paperwork is safe and private by asking: 

• How does the medical billing company go about sharing your patient’s data?
• Is there a backup plan in place in case a security breach is made or the system fails? 

At the end of the day, it is essential that you ask all the right questions to ensure that you are getting a full-service medical billing and coding company that can properly handle your practice’s needs. 

Looking for the Best Medical Billing and Coding Services?

Turn to MEREM Healthcare Solutions. Get a free quote and learn more about our uniquely designed support system for revenue cycle and operations management needs. At MEREM, we don’t just provide services, we deliver solutions. 

No matter the size, healthcare organizations need a strategic partner and that is what we are here to provide. Let us help you save time and ensure proper coding for all your medical billing needs. You will feel the difference through the level of dedication and commitment we provide to our clients.

The post Finding the Right Fit appeared first on MEREM Health.

When it comes to active healthcare claims processing, it is essential to create a process that maximizes efficiency to handle denied claims. Most medical practice administrators get worried when it comes to working claims, particularly when the claims are denied. It is essential to identify the potential income loss and begin an effective medical claims management process for handling these claims.

The good news is that every small improvement will make a significant impact on the cash flow of your practices revenue cycle. Here are some tips on how to accurately process denied claims and increase the overall performance of your revenue generation.

Track All your Claims

This may seem like basic advice, but the fact is that many healthcare providers do not track all their claims. The only way to define the problem is to use an effective method that will help teams keep track of denials so that they do not lose a single claim.

Complete Your Denials in a Week

If a claim was submitted incorrectly it will get returned or denied, then it needs to be corrected and promptly submitted again. Many health insurance companies place time limits to re-file their denied claims. By making denials a high priority and actively addressing them quickly you can ensure that they are not ignored or lost.

Identify the Problem Within Your Claims Denials

Monthly, you should look over all the denials and try to locate any trends that might be a cause for errors on a large scale (global errors). By identifying a specific issue that several denials have in common, the problem can lead you to take practical steps to rework the claims and to avoid future denials. This can protect your Time, Money and Effort.

What happens if you find out an excessive number of mistakes are being made? Do you take the time to re-educate your staff, or do you choose to outsource?

Check out our blog on how to combat claim denials.

Outsource your denial management process

A good solution will be outsourcing your denial management process to an expert company that focuses on Revenue Cycle Management solutions. When you outsource medical billing, you are handing over your revenue cycle management to individuals with extensive training. If you have a cavity, you go to the dentist. Similarly, if you have trouble with your medical revenue cycle, you outsource medical billing.

When choosing an outsourced healthcare solution to use, there are a few questions you should ask like,

• Do they use expert teams that are highly skilled in working with insurance systems?
• What are their turnaround times to get the denials addressed?

By outsourcing your denial management process to a medical billing company, you will have more time to focus your attention on patient needs. Interested in learning more? Check out this overview of MEREM Health’s medical billing services.

The post Tips For Improving Your Denials Management appeared first on MEREM Health.

If you could relieve stress on your medical team, as well as improve the profitability of your medical practice tomorrow, what steps would you take? We invite you to take time and consider how outsourcing your medical billing solutions could impact your practice.

Why Should You Outsource Your Medical Billing?

Relinquishing control of any aspect of your medical practice can be hard.

Our team at MEREM Healthcare Solutions understands the desire to be in control of the medical billing. But wouldn’t you rather have your healthcare team be less stressed while also knowing that payments are getting handled efficiently so that your profit margins are where they should be?

Let’s take a look at three reasons why you should really consider outsourcing your medical billing.

1. Your Dollars and Your Time Will Be Spent More Wisely

How much are you currently paying in overtime? Is your front office team working more on keying in information and handling insurance companies than spending with patients who walk in the door?

As a medical practice, you want your patients to feel welcomed and cared for as soon as they call your office or walk in the door. However, that is difficult for front office staff to handle as they juggle phone calls and if they are on constant hold with insurance companies.

By outsourcing your medical billing processes, you can obtain a knowledgeable and experienced team who stays up-to-date on the latest CMS changes. MEREM Healthcare Solutions can handle your medical billing needs while your healthcare team focuses on something more important—your patients.

2. Your Claims Will Be Processed Faster

Medical practices are no different than any other business. It needs cash flow in order to run and operate. Therefore, the last thing your medical practice needs is coding errors, late payments, insurance denials, etc., to impend on your operations budget and slow down your medical practice’s ability to turn a profit and run proficiently.

By outsourcing your medical billing to MEREM Healthcare Solutions, our professionals are able to streamline and speed up your medical billing process of efficiently filing claims while also reducing billing and coding errors. As a result, you are paid faster because these errors don’t occur, and many claims do not have to be re-processed.

Time is money. In fact, when medical billing processes are completed correctly, a claim can be reimbursed as fast as 7-14 days! How great would that be for your medical practice’s bottom line?

3. Your Patients Will Be Happier

Depending on the reason for their visit, patients can be nervous or anxious about their visit even before they set foot in your medical practice. This is especially true for our Ambulatory Surgical Centers and Advanced Imaging/Radiology clients.

When you outsource the time-consuming office tasks, your medical team is able to really focus on your patients and improve your patients’ experience by having more time to answering all questions and keeping them comfortable. When your patients are happy with their experience, you are able to see a faster return on billing collections and you will receive more positive patient feedback since your focus in on the patient and the quality of care you are providing is at the optimal level.

Discover how our team at MEREM Healthcare Solutions can help your medical practice.

Isn’t it time you give-away the paperwork so that you can get back to why you got into the medical field in the first place? Allow our team to handle your medical billing processes so that you can provide the quality care you desire for your patients!

Merem Healthcare Solutions, in Birmingham, AL, offers services for every step in a practice’s revenue cycle management. We can start from the beginning from credentialing and end with payment posting once an account has been satisfied. We offer a wide range of solutions which include auditing, billing, coding, consulting, credentialing, payment posting, practice management, and pre-collections training. Check us out on our website or on social media.

Feel free to call us to see how we can help you run your practice like a well-oiled machine. Call MEREM Healthcare Solutions today at (205) 329-7519.

The post Benefits of outsourcing your medical billing processes appeared first on MEREM Health.

From Cardiology to Orthopedics, Dermatology or Pain Management, if a patient has a poor visit at your medical practice, he or she is going to be less likely to make a payment once the bill is received. Rather than receiving the bill and turning a payment around in a quick manner, a negative patient experience can often lead to them just sitting on the bill and paying late – if at all. A negative visit is linked to a delay in payment time.

This payment process doesn’t do you, or even the patient, any favors, which is why it is important to consider outsourcing your medical practice’s billing so that your medical team can pay more attention to what is really important, which is the patient and his or her health.

Put Your Focus Back on Patient Experience

There is a huge correlation between patient satisfaction and the patient paying their medical bill upon receiving it in the mail. As a result, the medical billing team at MEREM Healthcare Solutions has found that medical practices can become more profitable when they come together to work on patient care with a third-party that is focused on billing and collections.

When the patient arrives at your medical facility, he or she needs to feel as though they are the only patient in the room. From the moment the patient signs in, to the moment the patient leaves the practice, he or she needs to feel like their overall health was the priority.

Yet, if the front desk receptionist is more focused on getting the patient’s payment rather than what he or she is there for, it can start the vicious cycle of a patient having a poor experience.  But, if a third party was involved in taking care of payments, then the patient could receive the quality care from the moment he or she walked through the door because the front desk receptionist could focus more on the patient and why he or she is there, rather than on payment collection.

It Is All Perception

Now, it is not to say that when your medical team is handling billing, too, that your staff doesn’t care about the patients. But, from a patient’s view, it can come off that way, especially if he or she is sick, tired, frustrated, etc.

By taking this one step off your plate, you not only take stress off your medical team so that they can focus solely on patient care, but you are also opening the eyes of patients to see themselves as more than just a payment to your practice.

Merem Healthcare Solutions offers services for every step in a practice’s revenue cycle management. We can start from the beginning from credentialing and end with payment posting once an account has been satisfied. We offer a wide range of solutions which include auditing, billing, coding, consulting, credentialing, payment posting, practice management, and pre-collections training.  Check us out on our website or feel free to call us so see how we can help run your practice like a well-oiled machine – (205) 329-7519.

The post Positive Patient Experience = Timely Payment appeared first on MEREM Health.

MGMA Stat from Sept 2018 shows an 86% increase in required prior authorizations.

To keep pace with changes to healthcare reimbursement, hospitals and healthcare organizations need to reduce inefficiency in their revenue cycle management.

One significant cause from revenue loss is claim denials due to lack of prior authorizations. You cannot work backwards to get retro-authorizations for most insurance companies.

Therefore, no prior authorization = no payment.

Take a deeper look…

How do your staff handle the ever-increasing demand for prior authorizations?

When prior authorizations for a procedure are managed, it’s often the front-desk staff or a nurse who fills out the orders and they are not often familiar with the medical necessity requirements set by each individual payer.

Also, doctors often think they know the payers’ medical necessity policies, but are not coding to the specificity that the payer requires.

Insurance must be verified prior to any service because pre-authorization is required for many plans.

While Medicare recently increased the demand for proof of medical necessity beginning Jan 2018, private payers have also adjusted their demands for individual policies resulting in confusion of requirements and increased claims denials. According to the MGMA poll in Sept. nearly 86% of practices polled said that they have experienced increased denials due to payer policy changes regarding prior authorizations.

Not all insurances are equal

Insurances have multiple plans that stipulate different coverages. Some plans only pay for specific services, some will only pay once a patient has paid down a specific amount, or after a certain length of time.

Regarding medical billing and coding, depending on the service, the coding/billing representative may need more information or historical documents in order to work the denied claim.

At MEREM Healthcare Solutions, we want to be your strategic partner in making sure your billing, coding, auditing, and other needs are met. Contact us today to learn how our knowledgeable and experienced professionals can help assist with issues associated with EMR and medical billing among your medical facilities.

The post How Do You Handle Prior Authorizations? appeared first on MEREM Health.

MEREM Health ranked among the Top 30 Medical Billing and Coding Blogs, Websites, and Newsletters to follow in 2018

According to Feedspot.com, MEREM Health was recently recognized as one of the Top 30 Medical Billing and Coding Blogs, Websites and Newsletters To Follow in 2018 because we are actively working to educate, inspire, and empower our readers with frequent updates and high-quality information.

These blogs selected in the list were ranked based on the following criteria:

• Google reputation and Google search ranking
• Influence and popularity on Facebook, Twitter, and other social media sites
• Quality and consistency of posts.
• Feedspot’s editorial team and expert review

Meredith Tibbs, Director of Coding for MEREM Healthcare Solutions was excited to be recognized among many of the organizational blogs that she follows and considers it a great achievement to be recognized among our peers. She said, “I use a lot of those other sites to keep updated within our industry!”

Anuj Agarwal, the Founder of Feedspot shared, ” This is the most comprehensive list of best Medical Billing and Coding blogs on the internet and I’m honored to have you as part of this! I personally give you a high-five and want to thank you for your contribution to this world.”

The post Top 30 Medical Billing and Coding Blogs To Follow in 2018 appeared first on MEREM Health.