No two billing and coding outsourcing firms are the same. As the healthcare market becomes more complex and competitive, it’s becoming increasingly crucial to choose the right firm for your needs.

We’ve compiled some key traits to look for when choosing a quality outsourced medical billing solution.

Transparency

False promises, claims generation delays and irregular follow-ups from medical billing firms can create major upsets in the financial health of your practice. Only choose to work with companies that are completely transparent about their policies, regulations, and history so you can understand and trust that they are a reputable company with a history of success.

Additionally, firms that utilize cloud-based technology to allow you to view your financial data whenever you need should be your first priority. Cloud-based firms provide an opportunity for clients to view their data in real-time, including denials, charges, collections, filed claims and payment summaries.

Technology

Pay close attention to a medical billing and coding firm’s technology. What technology are they using? Is it modern, capable technology that blends different practice management solutions to effectively manage your unique financial needs?

Most importantly, when deciding between firms, ask questions about how each firm’s current technology will help streamline your current business model. If your practice is fully digital, is this firm capable of onboarding your data effectively (and without snags)? Or, if your practice uses paper charts and documents, how will a firm handle that data and develop a secure and compliant process for your sensitive information?

Security

If choosing to use a cloud-based medical billing firm, make sure they are using every possible metric to secure your data, whether while in transit (moving across networks) or at rest (stored).

Because patient data is highly-sensitive, HIPAA compliance is crucial. Ask potential firms about their HIPAA compliance so you’re aware of your patient’s future security with this firm. Without question, do not settle for firms that can’t prove, with documentation, their level of compliance for risk potential. Also, do not use firms without a reliable track record of trained professionals handling compliance policies.

Competitive Pricing

Choosing a firm for its low price-point may seem like a wise financial decision, but what possible services could you be losing out on for that lower rate? Conversely, choosing a firm with a higher rate might not translate to better, more robust services.

With any financial decision, spend time analyzing the value and cost of each potential firm. Compare each firm’s rate and offered services and find the best value for your unique healthcare practice. Don’t get sacked into a higher (or lower) rate that isn’t delivering the metrics you need for financial success.

Prepare Questions For Outsourced Healthcare Solutions

Finally, prepare any questions that might not be immediately answered in an FAQ or email introduction.

Ask questions about

• follow-ups
• price points
• compliance policies
• security/encryption
• claims
• willingness to adapt to your processes
• payment turnarounds

Whatever you’re curious about, this is the opportune time to ask before signing paperwork you might not fully understand. Doing the upfront work of asking important, relevant questions specific to the improvement and performance of your revenue cycle management, will ensure you’re happy with your medical billing and coding firm in the long-term.

At MEREM Healthcare Solutions, we want to be your strategic healthcare solutions 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 specialty providers and practice owners with issues associated with EMR and medical billing.

MEREM Healthcare Solutions is a Birmingham, AL-based company that has been providing exceptional medical billing and coding services to physicians and specialty healthcare practices since 2008.
We pride ourselves on not just maintaining, but exceeding, the level of accountability, communication, and customer service that is valued in traditional, on-site billing departments.

Please check out our other blog posts, or contact us to learn more.

The post You Need a Medical Billing Firm – Have You Considered These Qualities? appeared first on MEREM Health.

Clinical documentation is at the core of every patient encounter. It is to document the care provided to the patient, as well as to communicate with other providers. In order to be meaningful, it must be accurate, timely and reflect the scope of services provided.

Elaborate on Quality of Care

Make clinical documentation improvements about quality! When improving clinical documentation, physicians should focus on the opportunity to validate and expand on the quality of care provided.

Markups Are Not Recognized Documentation

Fee tickets and superbill markups are not considered valid documentation and are not recognized in an audit. E/M levels, procedures, and diagnostic readings must be documented in order to reflect the quality of care and services provided.

Remember, If you did not document it, it did not happen!!!

Organizations need well-rounded individuals who can effectively articulate all the pieces:

• documentation requirements
• code assignment
• coding guidelines
• quality reporting

MEREM Healthcare Solutions can help!

Visit our website at Meremhealth.com for more information and be sure to take the opportunity to schedule a free consultation with Merem Health.

MEREM Healthcare Solutions is a Birmingham, AL-based company that has been providing exceptional medical billing and coding services to physician practices and ambulatory surgical centers since 2008.
We pride ourselves on not just maintaining, but exceeding, the level of accountability, communication, and customer service that is valued in traditional, on-site billing departments.

Please check out our other blog posts, or contact us to learn more.

The post Validate Care Quality via Procedure Documentation appeared first on MEREM Health.

A friend of mine had a bill from a lab for $1,200. As a nurse practitioner herself, she knew there was no way a routine lab could cost $1,200 (that’s crazy!).

She emailed us with this, “Hope everything has been going well for you. I had a quick question and thought you may be able to help me. So, I went to my MD for some routine blood work because I had been having some weird headaches and I get this bill in the mail for $1200 for the blood work because my insurance straight denied the claim. They said the diagnostic codes were coded incorrectly but wouldn’t give me any more information? When I talked to the doctor’s office, they didn’t have any clue on how to fix it. I know you all have experience with this. I was curious if you may have any ideas on what went wrong? I can send you a copy of my bill if you need to see it. I’m at my wits end here!”

This is what feels like the thousandth message like this I have received this year. “Yes, I can definitely help! This happens often when visits are inaccurately coded. What type of insurance do you have?”, I replied.

She replied with, ” Here is the bill I got…” I am not disclosing her personal information for obvious reasons, though I have her consent to share this story.

As a Certified Coder, I knew this was incorrect. Most doctors do not perform procedures, diagnostic tests, etc. unless there is an indication for it (medical necessity).

Together, we called the billing office that had sent this outrageous bill. With her consent, I was able to talk to the billing office. I said, to the nice billing representative, “ma’am, she is being billed because the insurance is not covering these charges stating they are non-covered. What diagnosis was billed for this blood test?”. I asked this question because, being in the billing industry for some time, I knew medical necessity (non-covered) denials come from inaccurate diagnosis coding.

She responded, ” The diagnosis billed was for hair loss”. My friend immediately chimed in, “but I never said I had hair loss nor have I ever had hair loss.” I knew right then, we had found the issue…. Inaccurate coding.

So often, billing offices and practices put more attention to procedure coding because it drives revenue, but they still must be accurate in diagnosis coding. My friend, referenced in this article, will likely never go back to this lab. It’s not because of bad customer service, and not because the facility could have been nicer. It’s not because of anything other than they didn’t look competent due to inaccurate billing. Your billing office reflects on your practice, whether you like it or not.

About 30 days after I helped this friend resolve her bill, she called me to share the outcome. Apparently, instead of owing $1,200, she owed part of her yearly deductible ($115.87). We essentially saved her over $1,000! I can only imagine what would have happened had she not asked MEREM Health for some friendly assistance.

Make sure you have the right billing staff in place! Call us today to see how MEREM Health can help your practice.

The post Are your patients receiving inaccurate bills from your billing office? appeared first on MEREM Health.