With ever changing healthcare regulations and evolving high tech healthcare industry, the profitability of your practice can vary dramatically based on how attentive you are to your medical billing reports.

Medical billing involves payment for your services by the patient or reimbursement by claim carriers like insurance companies, Medicare, Medicaid, etc. The entire process of medical coding, billing and filing claims involve constant scrutiny and technical knowledge at every step. Most physicians attempt to maintain in-house billing and coding, in order to keep losses and costs on a tighter leash. However, simple outsourcing and simpler analysis of regular medical billing reports can work wonders for your profitability.

Providers and patients both are acutely aware that medical coding errors are the core of many billing issues. Medical coding and billing is becoming increasingly complex, and at times larger hospitals require more than 200 people involved to generate a single medical bill.

As certified coders provide proof of coding knowledge and competence; healthcare facilities to increase their revenue, prefer to hire a certified coder to avoid unnecessary coding errors.

Industry Standards State

A survey result depicted certified billers and coders earn approximately 20% more than their non certified counterparts

Denials make up an important part of the cost of running a practice as services provided but not paid can significantly affect the profitability of a practice. But the increasing complexity of insurance contracts, falling reimbursements and claims denials are a harsh reality for most practices today.

In the current demanding healthcare environment a good billing system which can accurately recognize denials, denial trends and their causes is a requisite to high productivity and reduced costs.

Industry Averages

The consistent rise in demand for Gastroenterology services has really been a boon for clinics and hospitals. But the growth has been so overwhelming that it started affecting their reimbursements in a big way. While practitioners have generally been preoccupied with clinical duties, their medical billing staff have found the voluminous growth simply hard to cope with. As a result, there may been considerable delay in processing claims, leaving physicians’ bills to pile up as ‘account receivables’.

It is an irony that Medicare and Medicaid, which reimburse more than the half of the nation’s total health insurance, have come in for heavy flak by physicians, who claim to have lost considerable revenues that they could otherwise have rightfully earned had they avoided seeing Medicare and Medicaid beneficiaries and favored patients with private health insurance policies.