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heavily on technology can be risky if there are system failures, technical glitches, or if the software becomes outdated.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

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.

Below, our professional biller and coders have provided some information about the benefits of outsourcing your medical billing and coding.

Medical Coding and Billing Services – Why Outsource?

One reason to outsource your medical coding and billing is that it frees you and your staff up to care for your patients.

When your staff are rushed because you’re clinic is busy or running behind, it is easy to make mistakes. Your patients will be taken care of more effectively at your practice with billing and coding taken off of your staff’s plate. Outsourcing this time critical solution to our certified medical billers and coders will be able to dedicate their time fully to coding and following up on unpaid claims, resulting in more claims being processed in a timely manner with fewer errors.

Accountability for Coding Errors

The CMS modify codes on a quarterly and annual basis. Incorrect coding, or miscoding, is likely for any medical practice that does not implement ongoing CPT code training for their medical coders.  Medical coding errors may lead to major delays in payment reimbursements and payer audits, which hurts your practice. Failure to provide correct coding can cause these payments to be delayed, denied, or limited.

MEREM Healthcare Solutions has found that an alarming majority of claims are rejected or denied upon initial submission. The reimbursement for denied claims depends on a practice’s efforts for correcting and resubmitting claim denials. You can avoid this problem by outsourcing your medical coding to certified professionals who have already become familiar with the new coding system and pursue ongoing training for relevant CPT code changes that directly affect our practice specialties.

When practices utilize outsourced medical coding solutions,

1. fewer mistakes are made
2. better care is given to patients
3. and billing cycles run smoothly.

Certified Coders Do More Than Just Submit Claims

It’s not uncommon for people to have multiple insurance companies. A professional, certified coder will make sure that each claim is submitted properly. Our expert coders have the correct software and expertise necessary to submit claims to all of the responsible payers while staying compliant with CMS and payer guidelines.

If any of your claims are denied, our billers can also handle the appeal process. Outsourcing your medical coding will ensure your revenue cycle is always running as smoothly as possible. (Did you know in-house medical coding costs more? Outsource!)

Ready to Outsource Your Medical Coding?

MEREM Healthcare Solutions, located in Birmingham, Alabama offers medical coding, billing, and revenue cycle management services to clients across the nation.

We are familiar with all of the ICD-10 and ongoing CPT changes upheld by CMS and MEREM Health will provide you with superior service for a fraction of the cost of our competitors! Contact MEREM Health today or request a FREE revenue cycle audit to find out how your medical coding can be enhanced with our dedicated expert medical coding team.

The post Should You Outsource Medical Coding? Yes! appeared first on MEREM Health.

Managing your practice’s revenue cycle requires an honest look at your current workflow. From front office pre-collections to denials management, MEREM Health wants to help you determine what is working and what isn’t by offering a Free Revenue Cycle Audit. Before you proceed, there are 5 practical questions you should answer to better prepare for your next revenue cycle assessment.

1. Do your patients know that their payments are due before the come in to see you?

Are your front office staff aware of and clearly communicating the patient’s financial obligations or are you assuming that patients know what is due? Check to make sure your policy is listed on your website and on all billing statements to make sure they get it.

2. Are you checking your Collections Report daily?

Like the speedometer in your favorite car, you’ve got to keep a watchful eye on your daily collections to ensure that revenue loss isn’t stacking up daily. Your investment of time in making collections monitoring a daily practice will help you to quickly see

• how many patients were seen that day
• how much money was collected
• how many patients were collected from

If a patient wasn’t collected from, your report should also explain why that occurred. This will be useful tool in keeping your front office staff accountable.

3. How do you hold your front desk accountable and what measurable performance do you review?

Pre-Collections are just a part of their many responsibilities. Make sure that your front desk staff are accurate in collecting patient information, reviewing and collecting patient deductibles, copays, and past due balances. Also, be sure to look at their preauthorization efforts in comparison to claims denial causes.

4. Have you invested in technology and continuing education?

In order to have the most efficient billing process, your technology must be up to date. EMR, scheduling programs, and medical billing software can make a big impact on streamlining your practice’s financials and workflow.

Also, ongoing training for your staff is a timely but beneficial investment to ensure they are properly trained and up to date on all policy changes and are knowledgeable of filing deadlines.

5. What are your KPIs and how are they performing?

Comparing monthly reports can provide a clear indication of existing data trends. Monthly reporting does a great job of showcasing your monthly spending, which is important for budgeting in the present, but it does not do a proficient job of illustrating trends and overall revenue cycle performance. Custom Reporting is a great asset to collect and evaluate trending data.

If you do not monitor your monthly reporting, months can go by and many practice owners have no idea whether their practice has grown or at least maintained and balanced their revenue. A monthly dashboard with custom performance metrics is invaluable. [For More Information…]

MEREM Healthcare Solutions offers a FREE Revenue Cycle Audit and Practice Consultation Solutions for specialty clinicians, groups and healthcare entities. We deliver custom healthcare solutions to help you better understand your practice performance. If you are in need of consulting services for your medical practice or would like a revenue cycle audit performed, Request a Free Consultation with MEREM Health today.  For more information, call (205) 329-7519.

The post Five Practical Questions to Answer Before Your Next Revenue Cycle Assessment 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 could I gain from doing an audit? GOALS

The results from any audit are measured against industry benchmarks. If you are struggling to meet or keep up with these standards, a billing and coding audit should be performed in order to help you understand the key areas where your clinical operations are weak and help you to identify priorities and set goals toward making improvements that impact your revenue cycle.

At MEREM Healthcare Solutions, we call these standards, Industry Benchmarks, and it is our mission that all of our clients meet and exceed industry benchmarks.

What is a REVENUE CYCLE AUDIT?

A practice operation review tool used over a period of time to help you improve your current revenue process. We believe that routine, internal audits of your billing and coding processes are necessary. Every time an audit cycle is completed, there should be further improvement in patient care.

WHAT ARE INDICATORS THAT IT’S TIME FOR A REVENUE CYCLE AUDIT?

Is your practice losing money? – An audit will help you identify revenue loss and set goals focused on profit potential.

How quickly are your claims being followed up upon initial denial? – Efforts to reduce claim denials should begin with a revenue cycle audit to help you identify the source of denial trends.

Are you confident in your in-house/outsourced coding accuracy? – Coding services are the life-blood of your practice. That is how the services you provide are transformed into billable revenue.

A complete Revenue Cycle Audit includes:

• Coding accuracy audit
• Billing and accounts receivable audit
• Industry Benchmark Comparison for your individual practice

Conducting a revenue cycle audit in-house may take away from your daily responsibilities, and be a daunting task. Considering an outsourced solution for conducting your audit will help you stay on track and focused on continually improving your processes.

Whether you currently handle your billing and coding in-house or outsource to another company, MEREM Healthcare Solutions can provide you with an unbiased industry comparison and revenue cycle audit report to assist physicians and practice managers with improving their practice performance. Our audit results are always kept confidential for our client’s internal use only.

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 Auditing With NO Fear, NO Frustration and NO Faults appeared first on MEREM Health.