Processing an insurance claim is rarely as simple as it may appear. In an ideal world, the claim's reimbursement arrives swiftly and without any processing roadblocks. However, anyone in the medical billing field understands that careful attention needs to be paid to each claim and careful follow up performed in order to maintain a high clean claim rate.
Careful and diligent medical billing follow up is crucial because you need to:
Operate within the carrier's time limits for filing (timely filing limits) Each carrier maintains its own time limits for claim filings. Careful medical billing follow up will allow your practice to meet the variety of time limits to ensure maximum payment. If follow up is delayed your practice may miss payments owed simply because a filing deadline was missed.
Identify mistakes Often times a simple mistake can lead to a delayed or rejected payment by no mistake of your own. A patient's personal information may change, an insurance policy may be different, or the claim submission process may be altered. In these cases a simple mistake can lead to a missed payment. Medical billing follow up will help you identify these mistakes and rectify them before a payment is lost.
Avoid appeals The appeal process can be cumbersome and challenging to providers who simply want a chance to contest a lost payment. Although the appeal process will benefit providers at times, saving the time and hassle via effective medical billing follow up is the best solution for healthcare revenue cycle management.
As the medical billing codes and procedures continually change and evolve with the impending implementation of ICD-10, Healthcare Information Services (HIS) may be a smart solution for your practice to aid in billing, coding, claim submission, and the critical follow up.
HIS is a full service physician management company specializing in revenue cycle management and technology services. HIS provides services in billing, accounts receivable management, coding and appeals, cash flow management, electronic medical records, IT practice management, consulting, etc. You know that in order for your practice to receive its optimal medical reimbursement the healthcare revenue cycle management must be active. HIS can provide the systematic and careful follow up on each claim that is vital to ensuring the funds necessary for a successful and profitable practice.
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