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Results-Driven Physician Billing Company
< 30
Days in AR
10-15%
Revenue Increase
97%
First Pass Ratio
96%
Collection Ratios
98%
Clean Claims Rate
Physician Billing Services We Offer
Is it getting harder to get paid for the services you have rendered to medically insured patients? It can be demoralizing when you stay true to your commitments - delivering quality patient care - but don’t get the reward. The process of reimbursement collection from insurance payers is not an easy one. There are several intricate steps that you must proceed through before every dime makes its way to your account.
Professional physician billing services are designed to streamline the process and let others do the heavy lifting on your behalf. Whether it is correct charge capturing, appropriate code reporting, timely claim filing, or error-free payment posting, these services efficiently manage all the aspects of physician billing. MediBillMD’s suite of physician billing services includes the following.
Common Challenges in Physician Billing
Physicians countrywide are finding it increasingly challenging to navigate the system and sustain their practice in the complex, competitive, and constantly changing healthcare landscape. Even after dedicating 20-25 hours per week to paperwork, nearly 80% of the claims filed to insurance payers are erroneous, leading to payment delays and denials.
From coding inaccuracies to information gaps and non-compliance to coverage issues, several factors can derail the physician billing process, causing providers to lose thousands of dollars in reimbursement revenue. An understanding of the hurdles that impede physicians’ journey to accurate and timely payment collections is a must for proactive denial prevention.
Complex Coding
Coding is the most challenging aspect of physician billing. It entails translating diagnoses, treatments, and medical supplies into standardized codes like the ones under ICD-10, CPT, CDT, and HCPCS coding systems. It can be difficult to assign appropriate codes from a list of thousands. Moreover, these lists are regularly revised.
Varying Payer Policies
From government to commercial insurance payers, each has its separate policies and specific billing requirements. Physicians find it taxing and time-consuming to thoroughly review each payer's contract before processing and filing claims accordingly. Unfortunately, non-adherence can lead to claim denials and revenue loss.
Missing Documentation
Complete and accurate documentation is often requested to prove the medical necessity of rendered procedures and services. Physicians may not get the time to maintain adequate documentation or compile and submit it as evidence with the claim form. Payers frequently deny claims because of missing referral letters and test reports.
Hasty Coverage Verification
Physicians must verify the patient’s eligibility and benefits before rendering healthcare. However, due to increased patient inflow and shortage of staff, they may perform hasty insurance checks, render uncovered services, and file reimbursement claims. This leads to claim rejections, write-offs, and bad debts.
Compliance Issues
Regulatory non-compliance is another significant hurdle in physician billing. Healthcare is a heavily regulated industry, and federal and state laws are frequently modified to protect patient’s rights. However, physicians may not be able to keep up with the changing regulations, and non-conformance leads to fines, penalties, and lawsuits.
Payment Disputes
Payment disputes may arise between the healthcare provider and insurance payer or between the provider and the patient, especially when denial notices are received and at the time of patient collection. In the case of copayments, coinsurance, or deductibles, the patient may dispute the bill, causing delays in payment collection.
Why Choose Us for Physician Billing Services?
The American Medical Association (AMA) labels physician burnout as an epidemic in the U.S. healthcare system. Around 63% of physicians show signs and symptoms of burnout, and research indicates that administrative burdens like EHR management and billing are the main contributing factors. In a separate study, the AMA also found that there is a 30% shortage of medical coders across the country, which only seems to worsen the plight of physicians
However, outsourcing physician billing services can save the day. At MediBillMD, we don’t just have a team of certified professional coders to ensure coding precision in the quickest turnaround time, we also diligently manage each step of the physician billing process for complete revenue cycle management (RCM).
MediBillMD’s A-team brings years of industry experience and physician billing expertise to the table. By partnering with us, you get instant access to AAPC-certified professional coders, trained billers, and revenue cycle managers who collaborate to formulate the best solutions to your billing problems.
We charge lower-than-market-average rates for our end-to-end, custom-made physician billing services. Our services cost less than 5% of your gross monthly collections to ensure you get the biggest returns on your small investment. We keep the price low and quality high to set a new pricing benchmark in the industry.
From federal laws like HIPAA and the No Suprise Act to state laws like the Statute of Limitations, we ensure regulatory compliance throughout our physician billing workflow. We work with a team of legal experts and regularly conduct audits to mitigate non-compliance, preventing penalties and legal actions.
Artificial intelligence and machine learning are the new normal in healthcare. Besides using advanced hardware and software, we leverage robotic process automation (RPA) to fast-track physician billing and, at the same time, ensure accuracy. RPA is an essential part of our charge entry, claims scrubbing, and data analytics processes.
Serving physicians in 50 states in 50 ways! It does not matter if you are employed at a large facility in the heart of Chicago or run your private practice in the wilderness of Rio Rancho. Our physician billing services have got you covered. With our remote operability, we can deliver billing expertise to physician offices of all sizes nationwide.
Physician billing excellence is now just a call away! Be it credentialing, charge capturing, coding, or compliance, we offer round-the-clock personalized support to all healthcare specialties, ensuring our clients seamlessly advance through the billing process. Our specialists are available via call and live chat 24/7, whether rain or sunshine, to troubleshoot billing problems for gynecologists, radiologists, neurologists, and hematologists alike. Get expert assistance when and how you want it.
Trusted by Physicians Nationwide
Our results speak for themselves! MediBillMD is a well-trusted name in the industry. Our physician billing specialists have optimized the revenue cycle of over 200+ verified practices.
Within two weeks of transitioning, I started to see payments come in again. MedibillMD’s communication is excellent. We meet weekly via Zoom, and there’s always someone available to answer questions. I finally feel supported and confident that my billing is being handled correctly. If you’re looking for dependable, professional billing support, I highly recommend MedibillMD.
Get In Touch With Our Physician Billing Experts
Whether you need assistance with medical coding or want to appeal denials, our qualified team of expert billers and coders is always ready to offer tailored support. Reach out to us over call, email, or live chat if you have any questions or queries regarding our physician billing services.
FAQs
At MediBillMD, we have curated a framework for streamlined physician billing, leaving ample room for flexibility and customization to cater to our clients' unique needs. We leverage advanced technology to automate repetitive and logic-based tasks like charge entry, claim scrubbing, and progress tracking, simultaneously enhancing the productivity of our workforce and ensuring speed and accuracy in our workflow. Partnering with MediBillMD means you get affordable, tailored, compliant, and results-driven physician billing services for timely reimbursements and improved cash flow.
The physician billing process at MediBillMD includes several sub-processes like patient eligibility verification, charge capture, medical coding, claims processing, claim filing, denial management, A/R follow-up, patient collections, payment posting, and data analytics.
Physician billing is the intricate, comprehensive, and often complex process of collecting insurance payments for the healthcare services rendered to medically insured patients. It is also known as professional billing and is distinct from hospital or institutional billing.
Physicians who own or work at a private practice have an assistant or a billing specialist to manage the administrative functions. Besides coding, billing, and claim filing, the assistant is responsible for patient scheduling and collections.
Yes. A physician assistant (PA) can bill a new patient visit. However, he must use his own name and NPI number on the Medicare claim form instead of the physician he assists. This is because Medicare does not accept “incident to” billing if an encounter has not taken place between a new patient and a supervising physician.
A physician can bill for laboratory services if the practice features a certified lab and the professional component of the test (analysis, interpretation, and reporting) was performed by the physician instead of a lab technician. However, the physician must comprehend the payer’s specific requirements for billing laboratory services to prevent claim denials.
Yes. A physician can bill for physical therapy services if the physical therapist works at the same practice and the billing is on his behalf, “incident to”.
