Month: March 2015

In-house vs. Outsourced- which billing option is best for you?

March 24, 2015 Posted on Categories AR Review, Billing Service, Uncategorized

by Michelle Tohill

 watch full Now You See Me 2 film

Many medical offices grapple with the decision to keep medical billing in-house or outsource it to experts. There are positives to both, so how do you find what’s right for you?

 watch full Now You See Me 2 film

First, you should consider the most important factors in any billing solution: cost, service, convenience and reimbursement success. It should go without saying that you deserve low cost, great service, great convenience and high levels of reimbursement success. However, many physicians believe that they can’t possibly get all four of those elements covered, so they suffer with high costs, poor service, terrible convenience and low reimbursement success.

 watch full Now You See Me 2 film

Usually an in-house team provides the highest level of convenience. After all, what could be easier than walking over to your biller and asking for an update? It also makes it easy for patients to ask question about their bills when you have the biller right there on-site. However, many physician practices experience very low rates of reimbursement success with their in-house team. This is usually due to the fact that the biller only has the time and skills to follow up on claims so many times, leaving many claims under-reimbursed. By working with your in-house billing team or bringing in a consultant to train them, you might be able to increase their reimbursement success.

 watch full Now You See Me 2 film

When working with an outsourced team, you may expect that you will receive lower levels of convenience. However, a good outsourced team will be just as available (via phone and email) as your in-house team. Another common problem with outsourced billing service is that they may not deliver great service, mainly because they are outside contractors, and thus you don’t really know what they are doing, when they are doing it, and how well they are performing. One fix for this problem is having billing software, which some medical billing services provide to allow physicians complete transparency into the billing process.

 watch full Now You See Me 2 film

The costs for in-house vs. outsourced medical billing service can vary greatly. If you have a smaller practice and your biller is multi-tasking, conducting multiple jobs, then it may appear that in-house is a cheaper alternative. However, you should consider the reimbursement success rate of your in-house team in this equation. Many times a professional outsource team of expert billers is able to gain higher levels of reimbursement, thus offsetting any costs associated with the service.

 watch full Now You See Me 2 film

Bonafide prides itself on offering medical practices all four elements of a stellar outsource billing service: our costs are directly tied to our reimbursement rates, so we are highly motivated to maximize your reimbursement; we deliver high levels of service and convenience, including free software with a billing dashboard that allows you to constantly monitor your billing data; and we have excellent reimbursement success. Let me know if you are considering an outsourced billing service, and I can provide a free AR review to tell you whether it will be worth your while.

 watch full Now You See Me 2 film

Michelle Tohill is Director of Revenue Cycle Management of Bonafide Management Systems and oversees all billing programs and processes. Her specialty is conducting AR audits to expose inefficient billing practices that fail to fully reimburse physicians for their work. She conducts AR audits and provides Bonafide customers with training and consulting on how to improve every aspect of billing and practice management to maximize revenue.

Minimize Claim Denials

March 13, 2015 Posted on Categories Billing Service, Medical Practice, Medical Software, Uncategorized

by Michelle Tohill

How many times have you gasped or grumbled as you read the words “CLAIM DENIED?”  Getting that “denial” stamp on your paperwork is indeed a cringeworthy sight.

The American Medical Association recently set out to quantify the administrative burden placed on physicians when they must rework claims and found that physician practices waste $14,600 each year on reworked claims through phone calls, investigative work and claims appeals.

3 Ways to Minimize Denial of Claims

1. Stay Current: The main way to minimize denials is by knowing the different insurance policies and being up-to-date on their individual policies. Each insurance provider has its own policy with regard to procedures, and it is essential that your billing staff or outsourced service is on the cutting edge of the changes. Luckily, this burden is slightly decreased by the fact that many follow Medicare guidelines, but there are still individually-based services and diagnostic codes that apply. Your billers should subscribe to the insurance newsletters notifying you of policy changes, so that you’re not caught off guard by new denials.

2. Follow Up: Also, every practice or billing company MUST, MUST, MUST follow up on denied claims rather than let the issue fall flat. It’s worth the effort to investigate procedure denials for the payment policies. Millions of dollars are left unreimbursed every year by medical billers’ failure to follow through to the bitter end and maximize the claim realization.

3. Check for Errors: The smallest errors on the billing side can result in denied claims. It is critical that your billing team diligently checks for errors before submitting claims, and then re-check any denied claims for errors before assuming there is anything else wrong. This will prevent unnecessary rework of claims that fall outside policy guidelines and save your practice time and money.

One thing we do at Bonafide that makes this process easier for us is that we have updated software to guide our claim process. This software means that our medical billing team doesn’t have to know every single daily change in insurance policies and processes. Instead, our software will flag any problems that may result in claim denials. Our team can then focus on relentless follow-up to make sure that all claims are adequately reimbursed. Another key element of our software is instant eligibility verification, which enables your front office staff to collect copayment up front and identify any potential issues down the road.

Michelle Tohill is Director of Revenue Cycle Management of Bonafide Management Systems and oversees all billing programs and processes. Her specialty is conducting AR audits to expose inefficient billing practices that fail to fully reimburse physicians for their work. She conducts AR audits and provides Bonafide customers with training and consulting on how to improve every aspect of billing and practice management to maximize revenue.

Contact Us

Bonafide Management Systems 241 Lombard St.
Thousand Oaks, CA 91360

805-908-2333 info@bonafide.com
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