Many providers today opting for to outsource their billing. The billing process is becoming much more involved in the last few years and for most it seems sensible to outsource. Between the software updates, required electronic filing of claims, NPI numbers, along with other changes, it has become nearly impossible for providers to maintain.
However, if you have only ever used one biller, Aba therapy billing services or one billing service, then you might not really know what you should be expecting from them. We've providers who use other services ask us sometimes "Should my billing service be achieving this for me, or is it something I have to do in my own office?"
It really is good to clearly know very well what your billing service should be doing, and what your office will be responsible for. This way you can keep things running smoothly. Not absolutely all billing services do things exactly the same way which is ok, as long as you know what yours does and it works for you personally. We actually provide different services for different accounts based on the needs of the office. For example, we do not normally get involved with obtaining authorizations, however we have several clients who cannot handle getting them from their office so that they pay us extra to take care of that for them.
But there are some items that all billing services should handle. Billing is not only the act of submitting the insurance claims and waiting for payment to come. A good billing service will submit the claims, electronically whenever you can, check electronic reports for denials and bad batches, and follow-up on unpaid claims. They should also look after any denied claims.
If they're not checking electronic reports and doing regular follow up then you are losing money and are also they. Electronic reports will notify you if you can find issues with any of your claims or with entire batches. If they are not reading them then they are not fixing those issues. For example, an electric report will return a claim if the ID number isn't right. Maybe this is a simple typo, two numbers got transposed, but if the electronic reports are not being read it could be a big problem. What if it is a patient that comes in once a week? None of the claims are going through as the ID number had not been fixed.
Many insurance carriers today have time filing deadlines. Some have become short, like 60 days from the date of service. If regular follow up is not being done then money could be lost due to timely filing. Follow up reports should be run every 4-6 weeks and all claims over 1 month should be checked on.
There are other things that billing services can do to help keep your accounts receivable running well, but those are the basics. If you feel your accounts receivable is not what it should be you might want to consider meeting with your billing service and asking what you can do to improve the situation. Inform them you would like a report of your accounts receivables. What are your figures over 30 days, over 60 days? They should be willing to provide you with reports of what is outstanding and why and it should not take greater than a couple of days for them to make the reports available. If they're unwilling to provide you with this information then you have to consider why.
I am not attempting to rat anybody out. I am just trying to make people accountable to providing the best service possible in order that billing services do not get a bad name. We hear too many stories of bad services also it makes providers leery of outsourcing when it is a viable option.
Business Name: Amromed LLC
Address: 205 48th St Apt 2, Union City, NJ 07087, United States
Phone Number: +1 609-993-0789
Website: https://amromed.com/
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