Physician Medical Billing Services
Get rid of lost revenue and manage account receivable backlogs effectively with our expert physician medical billing services. Our specialists ensure precise billing and coding, minimize revenue leakage, and enhance the financial stability of your healthcare practice.
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Streamline Outsourced Physician Medical Billing Services with Invensis
Physician billing is the systematic process of submitting and handling claims with health insurance companies to secure payment for services provided by physicians. The billing process includes accurately coding medical procedures and diagnoses, submitting claims to insurers, and overseeing the billing cycle to ensure timely payments. However, this type of medical billing is challenging due to the complex physician medical codes, complicated billing rules and regulations, etc. The billing complexity becomes more pronounced due to the absence of a proficient billing team while maintaining service excellence.
At Invensis, we comprehend the challenges associated with physician billing and, therefore, offer tailored solutions designed to tackle these challenges and relieve you of the burden. Our physician billing team works dedicatedly to keep your billing process compliant and streamlined by:
- Collecting patient details, including demographics, physician referral information, relevant insurance numbers (Medicare, Medicaid, or Social Security, and medical history.
- Confirming the patient's insurance coverage, eligibility, and benefits before providing services to avoid claim denials and unexpected out-of-pocket costs.
- Assigning billing experts for physicians to handle multiple billing models, including value-based billing, telemedicine billing, capitation billing, episode-of-care billing, etc.
- Translating diagnoses, treatments, and procedures into standardized ICD-10 diagnoses, E/M codes for service complexity, HCPCS Level II codes for specific procedures and supplies, relevant modifiers, and CPT codes required for insurance claims for the services rendered.
- Maintaining specific physician billing with correct CPT code ranges including 99201–99499 - office visits, hospital visits, consultations; 00100–01999 - anesthesia services; 10000–69999 - surgical procedures; 70010–79999 - radiology procedures, etc.
- Preparing and electronically submitting claims to insurance companies, ensuring they comply with payers such as Blue Cross Blue Shield Association, Humana, etc, maximizing potential reimbursements.
- Logging payments received from insurance companies and patients and applying them accurately to the corresponding accounts.
- Identifying and analyzing the reasons for claim denials, then taking corrective action to resubmit claims and recover revenue.
- Generating and sending bills to patients for any outstanding balances after applying insurance, including co-pays, deductibles, and non-covered services.
- Monitoring unpaid claims and patient balances and following up with insurance companies or patients to ensure timely payment.
- Generating regular financial reports and analyzing the physician billing data to identify trends, improve processes, and optimize revenue cycle management.
Our Comprehensive Physician Billing Services
- Insurance Verification
- Pre-Authorization Management
- Medical Coding and Billing
- Charge Capture
- Claims Documentation
- Claims Submission
- Insurance Claims Processing Services
- Denial Management
- Appeal Management
- Payment Posting Services
- Accounts Receivable Follow-up
- Patient Billing and Collections
- Fee Schedule Analysis
- Reporting and Analytics
- Custom Reporting Solutions
- Revenue Cycle Management
- Compliance and Regulatory Support
- Credentialing and Enrollment
- Audit Support
- Electronic Health Records (EHR) Integration
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During the consultation, some of the issues we can discuss are:
- Current challenges in verifying patient insurance coverage and benefits and how to streamline this process.
- Best practices for using CPT and ICD codes correctly to prevent billing errors and optimize reimbursement in adherence to healthcare regulations and payer guidelines.
- Proven approaches to handling claim denials, correcting errors, and effectively managing appeals.
- Cost-saving measures within the billing process to enhance financial performance and improve overall efficiency.
Why Choose Invensis As Your Preferred Physician Billing Services Company?
Invensis has over two decades of experience in offering physician billing services to independent physicians and medical practices, multi-specialty clinics, group practices, urgent care centers, and specialty care providers. Our physician billing specialists effectively handle every aspect of the billing process, from accurate coding to prompt claim submissions, ensuring maximum reimbursement. We develop and implement tailored physician billing solutions that align with healthcare practice's unique needs, accelerating revenue collection and minimizing payment delays. By focusing on efficiency and precision, we enhanced the claim reimbursement rate by 35% and attained a 97% first-pass claim acceptance rate for our clients.
Here are the key benefits of outsourcing physician medical billing services:
- Streamlined Revenue Cycle Management: Managing the revenue cycle efficiently is crucial but challenging, with multiple steps from charge capture to claim submission in physician billing. Due to this, internal teams often face difficulties in maintaining efficiency and handling high volumes of claims.
Outsourced physician medical billing and collection services streamline the entire revenue cycle process. By integrating advanced technologies and established workflows, they optimize each stage from charge capture to collections, improving overall operational efficiency and accelerating revenue realization. - Reduced Administrative Load: Internal billing departments frequently juggle numerous tasks beyond physician billing, leading to potential inefficiencies and distractions from core medical functions. This also dilutes their focus and affects billing accuracy.
Outsourcing to a professional physician billing service, relieves internal staff from the administrative burden of physician billing tasks. This allows them to emphasize patient care and other critical aspects of healthcare practice, enhancing overall operational effectiveness and patient satisfaction. - Improved Compliance and Regulatory Adherence: Keeping up with ever-changing healthcare regulations and payer policies in physician billing can be challenging, risking non-compliance and potential penalties. Internal teams may struggle to stay updated with regulatory changes.
Outsourced medical billing for physicians ensures adherence to the latest regulations and payer requirements. They engage specialized experts who are well-versed in compliance issues to reduce the risk of penalties and ensure that all billing practices meet current standards. - Optimized Claims Processing: Processing claims on the services provided by physicians efficiently is crucial to maintaining cash flow. However, internal teams may face claim submission and follow-up challenges, which may lead to delays and cash flow issues.
Outsourced physician billing and RCM services utilize advanced systems and their expertise to optimize claims processing. They ensure timely submission and effective follow-up on claims, reducing delays and improving cash flow management. - Scalability and Flexibility: Adjusting to changes in physician billing volume or healthcare practice size can be difficult with limited internal resources. Such growth or fluctuations strain internal processes and affect billing efficiency.
Outsourcing offers scalable medical billing solutions for physicians that adapt to billing volume and practice size changes. This flexibility ensures that billing operations remain efficient and effective, regardless of practice growth or changes in demand. - Advanced Technology Integration: Internal billing departments may struggle with outdated technology, leading to inefficiencies and errors. On the other hand, upgrading physician billing systems can be costly and disruptive.
Outsourced physician medical billing services utilize the latest technology and tools to enhance billing processes. These systems improve accuracy, speed up claims processing, and provide better data management, ensuring efficient and effective billing operations.
Here are some of the key trends in physician billing:
- Emphasis on Automation and Artificial Intelligence (AI): The use of automation and AI in physician billing is on the rise, with technologies that streamline routine tasks such as coding, claim submissions, and payment posting. Automation reduces manual errors, speeds up billing processes, and allows for more accurate and efficient handling of billing tasks.
- Expansion of Telehealth Billing: With the growth of telemedicine, experts are adapting telehealth services to physician billing. Billing for remote consultations and virtual visits requires new coding practices and compliance measures. As telehealth becomes more prevalent, physicians effectively incorporate these changes into their billing processes.
- Focus on Compliance with Payer Guidelines: There is a greater emphasis on compliance with payer-specific guidelines, including those from Medicare, Medicaid, and private insurers in physician billing. Adhering to these guidelines minimizes the risk of audits, avoids penalties, and enhances the accuracy of claims, ensuring smoother reimbursement processes.
- Transition to Value-Based Reimbursement Models: There is a growing shift from traditional fee-for-service models to value-based care, where reimbursement is tied to patient outcomes and quality of care. This transition requires physicians to adopt billing practices that reflect the value delivered and focus on efficient and accurate coding to support improved financial performance.
- Focus on Preventive Billing Audits: Physician practices are increasingly conducting preventive billing audits to check and correct potential issues before they lead to denials or compliance problems. Regular audits help maintain billing accuracy, improve documentation practices, and reduce the risk of financial penalties.
- Growing Trend of Outsourcing Billing Services: More healthcare practices outsource healthcare physician medical billing to specialized firms to leverage their coding, compliance, and denial management expertise. Outsourcing allows them to focus on patient care while ensuring that professionals manage their billing processes efficiently, reducing errors and enhancing revenue capture.
What Our Customers Say
We have been working with Invensis for the past two years, and they have helped us overcome many revenue cycle management challenges. The team often walks the extra mile to ensure that our needs are met.
Invensis has been our revenue cycle management healthcare outsourcing partner for the past 5 years. They have always delivered on their commitments, whether it is meeting our Service Level Agreement (SLA) or improving our billing process.
Invensis has been a great partner providing quality medical coding and billing services. The team is extremely responsive to every query we pose, and the turn-around time for deliverables is always as committed.
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