Medical Billing

5 Most Pertinent Questions Asked Regarding Medical Billing

5 Most Pertinent Questions Asked Regarding Medical Billing

There is perhaps only one constant in the medical billing industry, and that is ‘change’. The ever-shifting policies and protocols of medical billing have made it challenging to remain up to speed with all the changes and follow the correct pattern for medical billing. With such frequently occurring changes, the practitioners also grow curious in terms of knowing whether or not a medical billing service provider goes about their business in a favorable manner. With that said, following are some of the most pertinent questions asked by practitioners from the medical billing companies:


What is the function of the RCM?

Revenue Cycle Management (RCM) is the tool that records and maintains all the data pertaining to each and every patient. In the interest of complying with the complex set of rules, regulations and requirements to have the claims processed, it is mandatory to use the RCM software to maintain every single bit of accurate patient information down to the last letter.


1. What is the significance of the codes?

Codes are an important part of medical billing since allowing the practice to send the appropriate data to the insurance companies for payment purposes. The codes are constantly changing, which makes it crucial to remain up to speed with the latest codes. Not doing so can result in the wrong information transfer, ultimately leading to the denial of claims.


2. How can I (the practitioner) stay up to date regarding my payment Data?

Traditional means of communications and coordination between the practitioner and the medical billing company can only allow limited exchange of information for practitioners’ knowledge. In order to ensure maximum transparency and knowledge transfer, it is advisable for both parties to reach an agreement and opt for cloud computing. This way, the medical practice can have a complete grasp and knowledge of all the progress that is being made in the revenue cycle in real-time.


3. How are denied claims managed?

Rigorous follow-up and stringent information check are the keys to successfully manage denied claims. Recording the information is an incredibly complex phenomenon and is one of the most consistent reasons due to which the claims are denied. As a part of the error mitigation, if the information has been rectified and re-sent to the insurance company, a strong Medical Billing Company would engage in an aggressive follow-up and make sure that the claim is processed in a favorable time.


4. Can I not take care of medical billing myself?

A medical practice can manage their own medical billing if they wish to, however, it is advisable not to go down that route. Medical billing is an incredibly complicated practice and requires a dedicated set of individuals to look after different aspects of medical billing to make sure that it is done correctly. Therefore, in the interest of making sure that the revenue stream stays on a path of augmentation, it is best for a medical practice to avail the services of the best medical billing company.

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