Why You Should Outsource Your Medical Billing

Medical billing is the process that is used to submit and follow up on health insurance claims on behalf of the patient in order to receive payment for services provided by your facility. In the past, medical organizations used what we now consider an antiquated paper system. Now, this process has been significantly accelerated through the use of billing software and services that automate this process.

When running a healthcare business, it might be natural to allocate more attention to the healthcare aspect rather than the business side of it. With so much involved in the process, it can quickly become overwhelming. Shifting accountability of your business’s billing from your staff, which may not have all the latest training, to a team of experts who can process bills more efficiently, is only one of the pros. 

Billing

Billing plays an integral role in all businesses as it adds structure to accounts. It is a three-party system that involves the patient, healthcare provider, and the insurance company, or payer. It is the medical biller’s job to arrange for payment between these three parties. In order to do this, the biller compiles the patient’s demographic information, medical history, insurance coverage, and the procedures that were performed, into a bill, also known as a claim. 

There are three stages to the billing process for every business. The first stage is invoicing, which allows the company to gather all charges and taxes for services rendered to a client. The second stage is known as the billing stage. During this time, the client is made aware of what they owe and are regularly reminded of their outstanding debt. In the event that a client fails to pay what they owe to the company, the third stage of billing is reached, which is known as the collection stage. 

Accounts Receivable

An important aspect of billing that must not be overlooked is accounts receivable, also known as an asset account. It is the money that is due from a client for services rendered to them by a business. This money has not yet been paid, but has a due date and is expected to be paid by the client. In the healthcare field, an example of this would be rounding up the costs of services provided to a client and then billing them the remainder that they owe after their insurance coverage. It is imperative to be fully aware of where money in a business is going and where it is coming from. It allows business owners to witness the flow of their money before, during, and after the billing process. 

Utilization Review

A utilization review, or a UR, is designed to ensure that each client is getting the appropriate care for their needs. It also helps to make future plans for care all while being aware of any adjustments that need to be made within the company to accommodate the clients. The most common reason to perform utilization reviews, however, is to verify that a client’s insurance company is going to provide their share of coverage for all final costs of the services rendered to the client. Those working on the utilization review for this purpose are responsible for trying to minimize costs wherever they can prior to sending a bill to a client. 

MJ Resource Management specializes in getting our clients the best possible payouts from insurance companies. We advocate for more client care, for longer stays in treatment, and fight to prevent our clients from missing out on revenue. With extensive experience in behavioral healthcare, on both an inpatient and outpatient level, the MJ Resource Management Utilization Review and Billing teams work tirelessly to ensure that you collect everything you are owed.

Medical billing can be a confusing and overwhelming process, but with the right billing services, businesses can prosper and thrive, all while providing their clients with the services they need to improve their lives. Knowledgeable billers have the ability of not only ensuring that payments are received, but also optimizing revenue performance for the practice. MJ Resources understands and diligently works through the billing process to ensure all requirements are met.