Services Provided By A Physician's Billing Service

For any physician’s office, billing is one of the most important jobs that they must tend to. No practice will be successful unless they are efficient at performing their billing functions. When a person has private health insurance, Medicare and/or Medicaid, the right type of claim and the correct coding must be used with the exact information for the patient and the doctor’s office. That is the first area of concern where a physicians’ billing service can take some of the concerns off the physician’s office. The billing service will have an expert team who is current on coding policies and proficient at taking care of the claim submissions.

After the Claims are Filed

Once the claims have been filed, the job of the billing service isn’t over. If there are errors or a claim has not been received, the deadline for submission may pass. The result will be that the physician’s office will not be paid for the service. This is why it is important to follow-up on claims to make sure they have been received and are being processed. The physician’s billing service will keep records of the claims they submit and follow them up to ensure you get the maximum reimbursement for each claim.

Billings to the Patient

The majority of the services provided by physicians are not paid 100% by their insurance company. Sometimes the insurance company will not pay any of a claim because it is not covered, the deductible has not been met, or the insurance has lapsed or been cancelled. The majority of claims will result in an amount that is not paid which must be met by the patient. Patients must be billed for these amounts and pursued to get the total compensation for the medical practice.

Electronic Billing Process

Most medical practices today are required under HIPAA regulations to send billing claims for patients by electronic means. This gives a physician the advantage of being able to access each patient’s insurance company information to determine their coverage for the services they provide. Many billing services have software programs that allow the health care provider to access their patient records and their financial information online whenever it is needed. Depending on the physicians billing service you choose, the system may independent of the current system used in the medical office or it may be one that can be implemented and used with the existing system. This gives the physician the advantage of knowing when claims will be paid or denied and how much the insurance company is willing to pay for services rendered.

How the Billing Service is Paid

The services provided by the Physicians billing service will save the physician money overall by getting more claims submitted on time and getting fewer denied claims. The billing company will usually be paid by keeping a percentage of the revenue from the physician’s office, giving them even more incentive to get as many claims paid as possible. They will also save the medical providers a great deal of time so that they can focus on providing the best possible care to their patients.

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