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Things You Should Know Before Outsourcing To A Medical Billing And Coding Company

There are certain important things you should know before outsourcing to a medical billing and coding company

. These include the costs of outsourcing and the comprehensiveness of the services offered. Medical coding and billing are important processes involved when submitting claims to insurance companies. On this depends the payment that healthcare institutions, hospitals or doctors should get for the treatment they provide. The medical billing company must be competent enough to make the billing process perfect.

Outsourcing to the medical billing and coding company should help you reduce procedural costs, save resources, streamline your functioning and make your billing process accurate so that you do not have to face claim denials. Timely reimbursement must be ensured. The medical billing company must be able to offer the following medical coding and billing services.

Medical Billing and Coding Services

Medical billing services:


Patient Scheduling

Patient Enrollment

Insurance Enrollment

Insurance Verification

Insurance Authorizations

Coding and Audits

Payment Posting

Account Analysis

Denial Management

AR Management

Financial Management Reporting

Medical coding services:

Hospital/in-patient coding

Emergency room e-code evaluation

Medical coding audits

Backlog coding resolution

DRG/ICD-9-CM coding validations

CPT medical coding

ASCs Ambulatory Surgical Centers Coding

ICD-9 coding based on AMA and CMS

Only if the services cover all these areas would there be real benefit for the healthcare provider. One of the key qualities a medical billing and coding company should possess is flexibility. The services offered should be able to be easily integrated into the functioning of the healthcare center.

Features that Make Medical Billing Outsourcing Successful

The medical billing company should also ensure total HIPAA compliance, without which its services would be meaningless. It should also stay with the times and incorporate diagnostic and procedural coding as well as new technologies. With the following advantages healthcare providers would not only be able to lose less in terms of partial insurance payments or rejected claims, but also be able to improve performance in their core areas:

Faster turnaround of the billing and coding

Assignment of an experienced project manager to oversee the reports and analysis

Flexibility in the choice of medical billing software existing billing software of the healthcare provider or the billing companys own web-based and EMR software

Experienced professionals and AAPC coders analyzing accounts


Maintenance and presentation of weekly and monthly reports consisting of projections, productivity, procedure code analysis, and more

Regular QA checks in the fields of AR management and coding, and for ensuring clean claims

These are some of the things you should know before outsourcing to a medical billing and coding company.

by: mososi
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