What's an All-in-1 Medical Billing and Provider Credentialing Service?
BellMedEx Medical Billing and Revenue Cycle Management Services
Complete revenue cycle management services from the highest reviewed RCM partner working within your choice of platform.
The healthcare industry is complex, with intricate billing and reimbursement processes that can be a significant burden on medical practices.
Also, being a demanding task, medical billing can be quite challenging for providers without access to the required manpower who is skilled as well as experienced to perform the tasks with agility and accuracy.
This is where an ALL-IN-ONE MEDICAL BILLING AND PROVIDER CREDENTIALING SERVICE can become a game-changer for medical practitioners.
What is an All-In-One Medical Billing And Provider Credentialing Service?
An All-In-One Medical Billing And Provider Credentialing Service is a comprehensive solution designed to handle the entire financial cycle of a healthcare practice. It offers a holistic approach to managing the complex tasks associated with patient care, insurance claims, claim submission, denial management, and provider enrollment.
Essentially, it's a one-stop-shop for medical practices seeking to streamline their operations and improve their financial performance.
By outsourcing these functions to a specialized full-service company, healthcare providers can focus on delivering quality patient care without being burdened by administrative tasks.
Let’s look at the integrated services offered by an All-In-One Medical Billing And Provider Credentialing Firm, below:
?? Medical Billing
Medical billing is the first component of an All-In-One Medical Billing And Provider Credentialing Service. The process is a three-way communication between providers, patients, and payers. A clear and effective communication is responsible for the satisfaction of all the parties involved, accurate processing, and timely collections.
Each step that comes under medical billing is executed by the third party, all-in-one medical billing service. Medical billing process encompasses the entire financial cycle from patient visit to payment posting to reimbursement.
Let’s look at each step individually and in more detail:
Medical billing flow chart begins the moment a patient enters the healthcare facility. It involves the collection of necessary patient information and entering the data in an Electronic Health Record (EHR) software for easy access at any time and from anywhere by the authorized personnel. Once the information is gathered the front desk office schedules the patient appointment with the doctor.
The data gathered includes;
?? Patient name
?? Address
?? Contact information
?? DOB
?? Insurance provider’s name
?? Policy number
It’s important to note that the success of the entire medical billing process up to the reimbursement depends upon the accurate collection of the patient information.
Verifying patient insurance eligibility and benefits prior to services is essential to ensure the reimbursement for services yet to be delivered. Once the patient’s insurance information is collected, it’s time to confirm your patient’s active insurance status from their payer. Here’s how you can verify;
?? Collect patient’s insurance information i.e.; patient name, DOB, insurance payer’s name
?? Contact the insurance payer for verification via mail or direct phone call
?? Gather all the benefits information, insurance plan details, pre-authorization requirements, secondary insurance information, and record it in your EHR for future reference
Note: It’s recommended to re-verify the patient’s insurance information every month to avoid any discrepancies during claims processing.
Entering charges involves the transcription of delivered medical treatment, diagnoses, or procedures into codes that are readable by the insurance companies. The claim generated is submitted to the appropriate payor for billing.
An All-In-One Medical Billing Service makes sure accurate claims are generated that follow the HIPAA guidelines and adhere to the latest billing, coding, and RCM regulations.
A Full-Service Medical Billing Agency performs thorough audits to ensure accuracy and help the provider identify the loopholes in a medical billing process leading to reduced revenue collections.
?? The audit team scans and identifies specific errors and scrubs the claims using their claims scrubber integrated EHR software.
?? The integrated EDI clearinghouse helps recognize potential coding issues before the transmission of claims and resolves potential denials before the transmission.
?? The audit process validates the insurance policy, status of the patient's insurance, and identifies any potential billing errors that might delay the claims processing.
Preparing and transmitting claims to insurance payers and ensuring adherence to payer-specific guidelines are all maintained by the multi-functional medical billing service.
Not just submission but claims follow-up such as; persistent pursuit of denied, delayed, or rejected claims, and then identifying and resolving the denials is another important step in the reimbursement process.
The management of outstanding balance owed by the patients or insurance company to the healthcare provider begins the AR process. It involves the efficient management of accounts receivable to optimize cash flow.
The role of a Full-Service Medical Billing And Provider Credentialing Service is to file timely claims and reduce the Days in AR to less than 40 days.
Accurate and timely application of payments to patient accounts is essential to avoid any future discrepancies. This also maintains a clear financial record and keeps patients informed, for better transparency.. Generating and sending patient statements for balances due is also included in the payment posting process.
?? Medical Coding
Medical Coding is another most important component of an All In 1 Medical Billing And Provider Credentialing Service.
This clinical coding is a vital component of the revenue cycle and requires specialized expertise. Accurate coding is crucial for correct reimbursement. An omni-purpose medical billing firm typically offers the following coding services:
Assigning appropriate codes to diagnose patient conditions accurately.
Selecting correct codes for medical, surgical, and diagnostic procedures.
Coding for supplies, equipment, and services not covered by CPT.
Ensuring all billable services are captured and coded accurately.
Utilizing modifiers to accurately describe variations in services or procedures.
The coding process begins by gathering the patient information, entering the key details in the form of modifiers, and assigning accurate codes to the diseases, procedures, and services rendered.
Some of the advanced coding services an all-in-one medical billing service offers include:
?? Revenue Cycle Management (RCM)
An All-in-1 Medical Billing and Provider Credentialing Service offers end-to-end Revenue Cycle Management (RCM) that encompasses a series of processes aimed at optimizing the financial health of a healthcare practice.
RCM encompasses the entire patient financial journey from scheduling to payment. It includes:
Verifying patient demographics and insurance information for accurate and complete patient demographic and insurance information collection.
Obtaining necessary authorizations and pre-certifications approvals from insurance payers for procedures and services.
Ensuring all billable services are captured and entered into the system through accurate codes.
Implementing effective strategies to collect outstanding patient balances.
Generating reports and analytics to identify trends, improve efficiency, and increase revenue.
Preparing and submitting clean claims to insurance payers in a timely manner.
Pursuing unpaid claims, re-submitting corrected claims, and appealing denied claims.
Analyzing claim denials, identifying root causes, and implementing corrective actions.
Accurately and timely posting of payments and adjustments to patient accounts.
Managing outstanding balances, sending patient statements, and implementing collection strategies.
Here are some of the advanced RCM services offered by a full-service medical billing company:
?? Provider Credentialing
Getting the payers credentialed with maximum payers is also what an all-in-one medical billing and provider credentialing service helps you with.
Provider credentialing is a complex and time-consuming process that involves verifying a healthcare provider's qualifications and eligibility to provide quality medical services. An all-inclusive medical billing firm typically offers the following credentialing services:
Obtaining and maintaining Drug Enforcement Administration (DEA) and National Provider Identification (NPI) numbers.
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Enrolling providers with insurance payers.
Identifying the appropriate insurance payers to target for credentialing.
Completing and submitting credentialing applications to insurance payers.
Monitoring the status of credentialing applications and following up with payers.
Managing the renewal of provider credentials.
Other provider credentialing solutions offered by an All-in-1 Medical Billing and Provider Credentialing Service company includes:
?? Medical Audit Services
A medical audit is a comprehensive review of a healthcare practice's billing, coding, RCM, denials, payment collection process, etc to ensure compliance with regulatory standards and to identify areas for improvement.
An All-in-1 Medical Billing and Provider Credentialing Company typically offers the following audit services:
Reviewing medical records to ensure accurate and appropriate coding for services rendered.
Verifying that all billable services have been captured and coded.
Assessing the quality and completeness of medical documentation.
Evaluating adherence to regulatory requirements, such as HIPAA and Stark Law.
Some audit services offered in an all-in-one medical billing and provider credentialing service, includes:
Latest Tools and Technology used by an All-in-1 Medical Billing and Provider Credentialing Service
The healthcare industry is experiencing speedy digital transformation, and all-in-one medical billing services are leading at the forefront of this change. Here are some of the latest tools and technologies they are incorporating into their systems:
Practice Management Software (PMS)
This software handles administrative tasks like scheduling appointments, managing patient records, and generating patient statements. The market growth of PMS in the healthcare industry is rowing at 8.9% (CAGR) and is expected to reach $1.6 billion by 2027.
Electronic Health Records (EHR)
This digital system stores and manages patient medical information, including diagnoses, medications, and treatment plans. The EHR market value is constantly growing and is projected to reach $47 billion by 2027.
Clearinghouse
This third-party intermediary facilitates the electronic submission and processing of healthcare claims. An all-in-one medical billing service ensures the data is secure and transferred with thorough accuracy through their clearinghouse.
Artificial Intelligence (AI)
AI-powered tools can automate routine tasks like data entry, claim review, and eligibility verification, improving efficiency and accuracy.
Machine Learning
This technology can analyze vast amounts of data to identify trends, predict claim denials, and optimize revenue cycle management.
Telemedicine Integration
An all inclusive medical billing service allows Integration with telemedicine platforms for seamless billing and patient management.
Blockchain Technology
This emerging technology is used by a full-service medical billing company to improve data security, transparency, and interoperability in healthcare, adding $64 million to its market size by 2035 with a (CAGR) of 22%.
Other tools and technologies offered by a full-service medical billing agency are:
Robotic Process Automation (RPA)
RPA can automate repetitive tasks, such as data entry and claim follow-up, freeing up staff for more complex tasks.
Cloud Computing
Cloud-based solutions are helping medical billing firms deliver scalability, accessibility, and data security, enabling practices to access information from anywhere at any time.
Patient Portals
These online platforms allow patients to access their medical records, schedule appointments, and communicate with providers securely.
Benefits of an All-in-One Medical Billing and Provider Credentialing Service
An all-in-one medical billing and provider credentialing service offers a multitude of advantages for healthcare providers from reduced denials to accurate submissions, and great financial performance.
Here's how your healthcare practice can squeeze maximum results from an all-inclusive medical billing and provider credentialing service:
Financial Advantages
Operational Efficiency
Patient Satisfaction
Risk Mitigation
Focus on Core Competencies
By leveraging an all-in-one service, healthcare providers can significantly improve their financial health, operational efficiency, and patient satisfaction while reducing stress and administrative burdens.
A full-service Medical Billing Agency Vs. Single Service Medical Billing Company - Which is Better?
1?? A single service medical billing company focuses solely on medical billing, handling the coding of claims and submitting them to insurance companies for reimbursement. An all-in-one medical billing and credentialing services provider offers a wider range of services in addition to medical billing, such as credentialing, revenue cycle management, and EHR implementation.
2?? With a single service medical billing company, the practice has to handle other aspects like credentialing, EHR selection, and revenue cycle management separately by themselves or through other vendors. An all-in-one provider offers an integrated solution where all these services are handled together in a streamlined fashion under one roof.
3?? A single service medical billing company typically charges lower fees since their scope of work is more limited. An all-in-one provider may charge higher fees due to the wider range of services but can also potentially help the practice save money through bundled pricing and increased efficiency.
4?? With a single service medical billing company, the practice deals with multiple vendors for different needs which can lead to lack of coordination and accountability issues. An all-in-one provider offers a single point of contact, simplifying the process and ensuring clear accountability.
5?? A single service medical billing company focuses on short-term, transactional relationships to process claims. An all-in-one provider aims to build long-term strategic partnerships to help improve a practice's revenue cycle and business performance over time in a comprehensive fashion.
?? As a healthcare provider what do you think are your biggest reimbursement challenges?
From what we gathered by working with most healthcare providers, dealing with multiple third party billing, coding, RCM, credentialing, etc vendors can lead to reduced efficiency, increased overhead costs, reduced transparency in both pricing and billing tasks, while facing a setback in overall financial growth.?
These challenges can be mitigated once you outsource your tasks to a full-service medical billing company offering all billing services from coding, RCM, credentialing, denial management, submissions, audit, collections, and follow-up all under one roof to save time, effort, and money.
BellMedEx is the best All-in-1 Medical Billing and Provider Credentialing Service Company for you!
BellMedEx.com — a full-service medical billing and provider credentialing firm knows its game pretty well and has certified billers, coders, and RCM managers who get the work done to submit even the smallest claims.
We are a do-it-all medical billing company, offering end-to-end billing services from as low as 2.49%. At BellMedEx, our dedicated staff puts in the same efforts as you would and makes sure all your claims are submitted successfully and payments are collected faster.
Here's what we deliver:
? Offer A-Z billing services from billing, coding, RCM, credentialing, audit, denial management, collections, and follow-up
? Latest tools and technology to stay updated
? Speed up the revenue collection cycle
? Reduce billing and coding errors up to 97%
? Maintain the latest compliance standards from HIPAA to ICD10, CPT, and HCPCS coding
? File even the smallest claims, on time
? Get you onboard with maximum insurance payers
? Work on denials and rejections to reimburse maximum payment
? Advanced reporting and analytics
? Enhanced billing and pricing transparency
? Reduced Costs, starting from as low as 2.49%
We make sure you are not leaving any money on the table and reimburse all of what you deserve.