Tag: Workflow Management & Optimization

The Importance of Online Medical Billing and Coding

Guest post by Saqib Ayaz, co-founder, Workflow Management & Optimization.

Saqib Ayaz
Saqib Ayaz

In the present age, finding a professional and reliable medical billing professional is very hard. Every physician knows the importance of an expert medical biller for the management of cash flow. It would not be wrong to call online medical billing and coding the bloodline of the medical facility.

In this age of technology, hiring a medical biller is not appropriate when you can use the software to get the work done quickly. You have to make sure that you select the best medical billing practice management system that will work for you for decades. All you have to do is enter your practice and the method you use for testing and it would be easy for you to manage everything.

Recently it has been found that most of the physicians have just started their practice and they do not find it important to get the healthcare consulting services. What they do is simply divide the tasks among their employees. As a result, they might save some money but most of the time it is hard to manage data.

Medical billing is not an easy task because there are many particulars that you have to take care of. A mistake in a single figure will disturb the entire calculations and you will have to suffer. Apart from that, you will waste your time and money.

So it is better that you get the online medical billing and coding tools. Here are some of the things that you must consider before selecting the management system.

1. Timely filing

When you are dealing with the insurance companies, you will get only a few days to file the claims. In case you have missed the deadline, you will not be able to appeal a denial.

When the insurance companies miss the services, it gets even worse because the claims are often sent on time. It means you will have to deal with a denial. Such kinds of issues occur when the services are sent in a batch. The insurance company sent you five services and it skipped the second one accidentally and now the company will not pay for it.

With the help of online medical billing and coding system, you can have the detailed records of the time and date when services were sent. They will help you to prove the mistakes and so your denial will be appealed. It would be easy for you to get the payments on time. Most of the workflow analysis in healthcare use the clearinghouse system for the accuracy of the results. It makes the results more effective. The best feature of the billing system is that they provide guaranteed results and you will not have to deal with the errors in the billing or filing.

2. Follow up on denied claims with online medical billing and coding

The insurance companies use different methods for denying the claims and they will easily give you a solid reason for it.

3. Improve your communication with providers

When you have to log and compile the medical bill you have to make sure that the billing system and provider company are in-step. The healthcare revenue cycle management system has given a specific code to every patient. With the help of billing tools, you will be capable of expediting this category. However, you have to ensure that you maintain and check the system regularly.

With the help of electronic billing system you will get the following benefits:

You will never have to deal with virus or data hacks. It will help you to keep your contracts up-to-date with your insurance and provider company. It will manage everything from the requirements of HIPAA to billing compliance.

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Does the Concept of Value-Based Payments Make Any Sense At All?

Guest post by Saqib Ayaz, co-founder, Workflow Management & Optimization.

Saqib Ayaz
Saqib Ayaz

Regardless of whatever business you operate, the end goal is always customer satisfaction and healthcare is no different. Since healthcare is particularly valuable, it makes sense that the financial reward given to a valuable service should be high and based on a value model.

However, value-based models in healthcare do not have the same outcomes as they do in other businesses.

Value-based payments

Value-based payments have their advantages and disadvantages. For instance, on the one hand, value-based systems effectively liberate physicians from the constraints of fee for service so that they can concentrate on the overall health of their patients. Alternatively, some people say that value-based payment systems impose unneeded extra pressure on providers without necessarily getting the job done.

What is value-based payment in medicine?

Value-based systems reward physicians and healthcare providers with incentive payments for the quality of care given to patients with Medicare. These payment systems are part of a strategy to improve how healthcare is delivered and paid for. The purpose of any value-based system is to:

Effectively, value-based systems move toward paying doctors and healthcare providers based on the quality of care rather than the quantity of care given. Instead of charging patients based on the number of visits and tests that they order (fee for service payments), today, more hospitals are charging based on the value of the care that they give.

Fee for service payments

Traditionally, healthcare providers are refunded by third-party payers like insurance firms or by the government through Medicare or Medicaid. The amount of money that is paid is set at a going rate that is typically established by the agencies themselves. Since the budgeting of the costs and expenses are based on third party consumers, the system is marred by administrative hiccups, which has led to runaway care costs at the expense of the quality of care given and the patient.

The differences

The difference between fee for service and value-based payments lies in reimbursements and the quality of care provided.

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