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Relying heavily on technology can be risky if there are system failures, technical glitches, or if the software becomes outdated.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.

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.

What if your medical billing team went away tomorrow?

It’s happened to more than one practice.

Like many specialty medical practices, you probably have an in-house team that handles your revenue cycle management; From billing to coding, to auditing, collections, payment posting, claims re-submissions and dealing with payors. For some practices, this in-house arrangement works just fine, but have you ever thought about what would happen if your in-house team happened to fall apart, either because of employees finding other jobs or even retiring?

It’s every physician’s nightmare, but it doesn’t have to be. In fact, it might be time to explore another solution. A solution that would keep your revenue cycle management intact, no matter the circumstances of your practice.

Here are 2 significant advantages your practice would have if you considered outsourcing critical revenue cycle processes and leaving your team to focus on patient care and follow-up:

1. Many in-house medical billing and coding teams fail to keep up with changing regulations

Merem Healthcare Solutions Director of Billing Operations, Jennifer Smith, knows about this challenge intimately. She explains, “Carriers will change their policies and guidelines frequently. Without the proper knowledge and resources to stay up to date on these changes, this could be an extremely risky situation that could lead to lower reimbursement and an increase in denials.” Lower reimbursements and increases in denials obviously impact your practice’s bottom line in a big way.

When considering outsourced solutions, you will want to look for a strategic partner staffed with healthcare executives who have spent years in the physician practice space. These types of leaders have experienced these problems first-hand, and have developed proven solutions that have a mission of meeting or beating industry benchmarks, which are:

•  % of outstanding A/R = less than 120 days or -15% or less
• 30 days or less in A/R
• 97% or above net collection rate
• Coding accuracy above 98%

You should examine whether your existing office staff is currently meeting or exceeding these goals, and if they are not, you should consider outsourcing.

2. Many in-house medical billing and coding teams occasionally miss charges

Let’s face it, your in-house teams do a lot more than just billing and coding. In busy physician practices, they might also be asked to answer phones, do patient intake, and handle other tasks that interrupt their regular day-to-day jobs. It’s not their fault; it’s the nature of a busy, profitable physician practice. And when this multi-tasking is taking place, it stands to reason that employees are occasionally missing charges, among other things.

If this is the case at YOUR practice, you might consider an off-site outsourcing solution as a resolution to these issues that will invariably come up with an in-house staff. Jennifer Smith points out, “This is our team’s job every day, and they do it well. They have the resources available to locate and stop denial trends and/or carrier changes. They are not interrupted by other duties and responsibilities, as is what often happens within physician practices.”

As you probably already knew, there are several “gotcha” moments in the lifecycle of in-house revenue cycle management, which adds up over time in terms of revenue lost, inefficient productivity, and lack of ongoing training. Simplify your practice and your life by considering the advantages that outsourcing brings, and spend more time focusing on the things that are really important to you and 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 to see how we can help run your practice like a well-oiled machine – (205) 329-7519.

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 What if your billing team went away tomorrow? appeared first on MEREM Health.

A practice’s efforts to reduce claim denials should begin with an understanding of its greatest source of denials.

Run a series of denial reports over a period of time (3 weeks, or 3 months) that include:

• denial reasons
• procedure codes reported
• modifiers
• diagnosis codes
• payors

The results can be your greatest asset in identifying the source of denials. You can then sort the reports from each field to determine a particular coding issue and identify the greatest opportunity for your practice to focus on denials improvement.

Pay Attention to Timing

Although often unintentional, timely filing is a leading reason for denied claims. Each payor has their own filing deadlines that range from 90 days to 1 year. Failing to submit a claim within their assigned period will result in rejections that your practice may have to write off.

Even if denials have been reworked and claims adjustments have been resubmitted, the corrected claims must meet the original filing deadlines in order to be approved.

Poor management of claims can be detrimental to the financial health of a practice. Avoiding claims denials should be the responsibility of everyone in the practice. For more information about how MEREM Healthcare Solutions can help you combat claim denials, follow us on LinkedIn and check out future a continuation of this blog in the coming weeks.

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 Step by Step Efforts to Combat Claim Denial appeared first on MEREM Health.

The healthcare revenue cycle/reimbursement cycle is a very particular machine. All aspects need to work together just right and at the right time or the system breaks down. Merem Healthcare Solutions works with independent specialty medical practices to help improve your medical practice as a whole. MEREM Healthcare Solutions is dedicated to providing physicians and healthcare organizations with a uniquely designed support system for revenue cycle and operations management needs.

We have found that an alarming majority of claims rejected or denied on their first pass are in result of data entry errors that occurred at registration. Additionally, a large percentage of patient AR accumulates that could have, and should have, been collected in the office. With Merem Healthcare Solutions on your side, we will help you identify areas of improvement and help you hold your staff accountable. This is just one of the ways Merem goes above-and-beyond to act as your strategic partner towards our mutual goal of improving your revenue.

Enhancing Practice Performance in these simple steps

The first three priorities for providers and practice administrators are to

1.   Review staff roles and responsibilities,

2.   Monitor front office staff accuracy with a denial analysis

3.   Revamp billing processes to accommodate the changing landscape.

The fourth and next essential step is to complete a financial performance review.

While other challenges may need to be addressed to further enhance your patient flow, following these tips will help provide an excellent patient experience and accelerate your journey to operational excellence.  As a result, your revenue and overall practice performance can improve, too.

The post Enhance practice performance in these simple steps appeared first on MEREM Health.

Bracket Creep happens when receivables continue to age, moving from one period to another (ie: 31 days to 60) without improving.

If the accounts are getting older, the office may have a collection problem. The practice may not have a procedure for receivables collection or, if it does, the office staff may not be following it. It could also mean the office is understaffed and may need to hire someone to help with the billing and collection.

With a typical Medical Billing company, their patient collection efforts only go as far as issuing statements and generating “bad debt” reports of accounts that need to be turned over to collections. When accounts reach this point, we have found that less than 50% of these balances are ever recovered.

At Merem Healthcare Solutions, we work with our client partners to develop a Patient “Pre-Collections” strategy that is both aggressive and fair. We work with your front office staff and management to develop a Point-of-Service (POS) collections process to effectively collect more money up-front. Additionally, you will have the added support of a patient collections representative to your billing team. Our patient collections reps work diligently to collect patient balances in full or to make payment arrangements within 90 days and will help you identify and transmit delinquent accounts to a third-party collections agency of your choice.

Contact us for a free assessment of your patient AR to see how much money you could be leaving on the table!

The post Are You Aware of Bracket Creep? appeared first on MEREM Health.

Do you have a large amount of Medicare patients? Have you noticed your Medicare reimbursements have decreased or delayed? Are you seeing a large amount of Medicare denials and adjustments with no reimbursement for your services?

It is a very high possibility that you are correct when believing your Medicare reimbursement is lower than it should be. Medicare offers a wide range of plans and the majority of those are not the traditional red, white and blue Medicare. As an outsourced medical billing, coding and consulting company, MEREM Healthcare Solutions is seeing an increase in denials and loss of revenue for our clients due to this particular issue.

Areas most affected:

• Delayed or loss of revenue
• Authorizations, Pre-certifications, and Referrals
• Copays, deductibles and time of service money are not being collected
• Eligibility is inaccurate
• Increase in denials
• Improper billing
• Inaccurate records within the practice management system

What exactly is happening here and who is to blame?

Is the patient responsible? Is Medicare responsible?

What about your staff or your outsourced billing company?

Without proper training of your staff and/or outsourced billing company, your practice could be losing money. This is affecting the majority of providers, surgery centers, diagnostic centers, and much more across the United States. Simply put, time is money. Reimbursements that typically take weeks, end up taking months if you are lucky because multiple employees have to work an account’s error due to lack of training.

Another significant revenue loss in reimbursement revenue occurs when services are not being pre-authorized and a majority of payers will not allow you to obtain an authorization after services have been rendered.

This Medicare reimbursement and revenue loss is a trickle-down effect that starts with the patient and ends with payment posting, but almost always depends on the accuracy of your staff’s benefit verification and up-front collections practices.

MEREM Healthcare Solutions can help.

We know exactly what each of your staff should look for in this case. Your front desk and scheduling must be able to catch this prior to services being rendered so that providers can feel secure in being reimbursed for their services. This will bring you a much faster reimbursement, fewer write-offs and an increase in revenue.

Whether you need to improve your front office processes, improve clinic output, or need further coaching on your encounter documentation, this is where the MEREM Healthcare Solutions consulting team comes in to help your staff (and your practice) reach their maximum potential. We offer both on-site and remote training, so there is a solution to fit any size staff and any size budget. With Merem Healthcare Solutions on your side, we will help you identify areas of improvement and help you hold your staff accountable. This is just one of the ways MEREM goes above-and-beyond to act as your strategic partner towards our mutual goal of improving your revenue.

Contact MEREM Healthcare Solutions Today at (205) 329-7519 if you are observing significant reimbursement loss and would like to discuss your revenue improvement.

The post Have you noticed your Medicare reimbursements have decreased or delayed? appeared first on MEREM Health.

Our consulting team at Merem Healthcare Solutions is here to help you with training your front office staff to execute their more technical responsibilities such as processing new MBIs. We offer both on-site and remote training, so there is a solution to fit any size staff and any size budget. The Merem Healthcare Solutions consulting team comes in to help your staff (and your practice) reach their maximum potential at benefit verification and up-front collections.

Tips to Prepare Your Practice for New MBIs

1) Educate practice staff about the roll-out of new Medicare cards with new MBIs

The issuing of new health identification cards to all Medicaid and Medicare recipients begins April 1, 2018. These replacement cards will be distributed in phases over the next 12 months in an effort to prevent Medicare fraud and protect beneficiaries from identity theft.

Image Source: https://www.cms.gov/medicare/new-medicare-card/nmc-home.html, Obtained 2.20.18

2) Ensure your staff can identify the new Medicare Cards and MBI

• The new Medicare cards will have an updated look. These cards will be issued to a beneficiary for life and will not include any distinguishing demographics such as gender, birthdays, or signatures.
• Like the current HICNs, MBIs will be 11 characters long. However, MBIs will contain uppercase letters and numbers.
  • To avoid numbering confusion, MBIs will never contain the letters: B, I, L, O, S, and Z
  • Positions 2, 5, 8, and 9 will always be letters
• Each beneficiary will be assigned their own individual MBI. Unlike HICNs, MBIs will not be associated with their spouse or dependents.

3) Begin discussing the new Medicare cards with your patients now.

This will ensure they are prepared for the arrival of their new cards and know to bring it in with them to their next appointment.

Suggestion: Share this short video in your lobby https://youtu.be/DusRmgzQnLY

4) Beginning in April 2018, prompt your practice staff to ask a patient for their new Medicare cards

Eligibility responses include a message indicating that CMS has mailed new cards.

Merem Healthcare Solutions is happy to now offer consulting services to our client partners. Whether you need to improve your front office processes, improve clinic output, or coaching on your encounter documentation, Merem has a consultant that can help.

The post Is Your Practice Ready for the New Medicare Cards and MBI Roll Out? appeared first on MEREM Health.