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Medical Billing Services


Medical Billing Service Basics

Tired of dealing with HMOs and insurance claims? Medical billing services take much of the pain out of owning a medical practice by outsourcing the cumbersome tasks associated with billing and claims. The best place to start is by understanding medical billing service basics.

Medical billing services offer a convenience for busy medical practices, hospitals and physicians.

Rather than dealing with the headaches and hassles of billing and claims management, you can outsource these tasks to a qualified service provider. For a lot of medical professionals, a medical billing service is like a much-needed breath of fresh air.

Although medical billing services are useful, they still require a certain level of involvement from practices and providers, especially during the selection process. To make sure you are selecting the right medical billing service, you'll need to gain a high-altitude perspective of the industry and how a service can help your practice.

Why use a medical billing service?

Simply put, the reason many medical providers use a medical billing service is because they don't want to deal with HMOs and insurance companies. That alone is probably a good enough excuse to secure a billing provider. However, billing services also deliver other important benefits including reduced costs and higher collection rates. The bottom line is that a medical billing service will offload headaches and improve your practice's profitability.

How do medical billing services work?

Medical billing services earn a living by making the billing and claims process as easy as possible for their clients. Medical providers send patient information, insurance information, diagnostic and processing codes to the service. The service then verifies the information is correct, fills out claim forms and submits them to a claims clearinghouse. When the claim is approved, Explanation of Benefit forms (EOBs) are forwarded to you to complete the process. Medical billing vendors also handle patient billing and collections, yielding higher collection rates then you could secure through your own efforts.

What happens when a claim is rejected?

Medical billing services directly manage rejected claims. When a claim is rejected, the billing service provider makes the necessary corrections and resubmits it to the insurance company. Expect your vendor to deliver timely reports detailing the status of both claims and payments.

Do medical billing services offer any options?

Since it's their job to make your life easier, most services offer a variety of features and options designed to maximize your convenience. For example, you often have a choice of submitting claims via hard copy, secure e-mail, or through web-based or desktop applications. Technological options are usually preferred in medical practices that integrate billing with other software applications.

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