FQHC Billing Services: How to Protect Your Investment

Most physicians and federally qualified health centers (FQHCs) will face this one questions sooner or later: whether or not outsource your patient billing demands to more specialized medical and FQHC billing companies?

While there are many different FQHC billing software platforms and FQHC billing webinars available in the market, they are unable to outdo the efficiency of proficient medical billing companies. Hiring a third party to manage your FQHC medical billing is specially a good idea if you have a high staff turnover or you are someone who has stayed away from technology all your life.

These medical billing companies are capable of significantly increasing your revenue. You will finally be able to do without your inadequate billing staff. The company you hire will not only generate claims, they will also follow up with patients and ensure that all due payments are made in time.

Since there are many FQHC billing companies operating in the market, you must practice caution while hiring a third party to manage your billing. Here are a few things you must keep in mind when looking to invest in FQHC billing services that ultimately enables health centers to maximize revenue streams.

1. What are the services being offered?

FQHC billing companies, like MaximizedRevenue.com, can take over many functions, such as claim generation and submission, payment processing, creating invoices for patients, collection services, etc. Some billing companies also handle tasks like appointment scheduling and credentialing. However, the price tag increases with each new service. As a physician, you must ensure the FQHC billing company you hire takes care of all your requirements and does so at a reasonable price.

2. What is the technology being used?

Using a billing company does not mean you are acquainted from your responsibility. To reduce costs, it is necessary for a physician to understand how a medical billing company will operate.

• It is important to seek answers to questions like these: 
• How will claims be generated and shared? 
• How will the billing company maintain electronic records and how can these records be used by the hospital? 
• Will the FQHC billing company ensure data security? 
• Where will all the data be backed up and stored?

A good medical billing company will have clear answers to all these questions.

3. Are they experienced?

Hire a company that's been in business for a while. Though experience does not guarantee efficiency, it certainly builds up trust. Look for a company that is certified by the American Medical Billing Association. The AMBA certification evinces expertise in billing, insurance claims, reimbursements, fraud and abuse, medical technology and terminology, etc.

4. How does the company work?

A good way to gauge the performance of an FQHC billing company is to study their work structure. Different metrics like employment structure and number of employees, total years in business, number of claims processed in any financial year, total number of billings, etc, will give you an idea about the kind of results you can expect from the billing company you are hiring.

5. What is the price being demanded?

Money is an important thing. As a matter of fact, medical billing companies are hired to reduce the overall billing costs. Hire a company that is offering maximum services at a minimum price. Do not demand services you won't need. Ask the billing company to create a cost package based on only the services you will be availing.

How to Outsource Medical Billing Services to the Right Company

It is important for medical clinics and health centers to maximize their reimbursements to ensure they do not lose money and at the same time remain compliant. Medical billing and coding normally entails reading notes and medical files of medical practitioners and translating the prescriptions, diagnosis, and services provided into the appropriate codes for purposes of insurance claims.

A medical billing service provider submits the claims to the insurers and follows up on any denied claims. Medical billing mainly involves talking to insurers on phone to follow up on late payments or denied claims.

Outsourcing medical billing and coding eliminates stress and headache involved when performing these functions. It is highly advisable to leave such tasks to the experts. Here are tips for choosing the right billing services for a health center or clinic.

Sympathy & Diligence

All health providers should get paid for services rendered based on clinical guidelines, medical necessity, patient eligibility and benefits and reimbursement policy. The billing and coding company must be willing to fight so that claims are paid appropriately and reimbursements are done in a timely manner.

Good, Verifiable References

References are crucial to vouch for the billing company’s credibility. Whatever claims they make about themselves and what they intend to do in order assist the clinic or health center with billing and coding must be backed by verifiable and credible references.

Give Value & Offer Extra Benefits

A good billing service should do more than just entering charges, collecting money and getting paid by percentage. They should also be able to go for the extra mile to take care of the health center or clinic. For example they should check if the claims are properly coded and billed or whether all services and number of units are billed.

The company should have the knowledge and experience to put extra values in their work. They should be able to recommend a better method of billing and coding and educate the clinic or health center based on their knowledge from school and real hands-on experience. It is often a good idea to ensure the billing service provider has coding certifications. They should therefore be willing and in a position to offer free consultancy and support at no additional cost.

A Specialty-Focused Approach 

Select a billing company with years of experience in the health center's or clinic's area of specialization. This will ensure reimbursements are maximized and are also in line with the proper guidelines.

For instance if it is a cardiology clinic, the right billing service is one that has an existing cardiologist client or has vast experience providing an effective cardiology billing service. The billing company must have the ability and experience to read and properly process medical documentations relevant to the health center or clinic, for instance lab results and various progress and diagnostics reports.

This guarantees that money is not lost and yet compliance is maintained. The billing company should also provide comprehensive monthly reports for example productivity reports and patient and insurance balances aging analysis

Keenly Look at the Numbers

The medical billing company must be conversant with insurance EOBs (explanations of benefits). The company should know how to recover all underpayments and appeal for claims that have been denied erroneously. They must know about the health center's or clinic's contract rates and make a judgment on when is the right time to renegotiate the fees. They can offer guidance on how to negotiate for fees or even do the negotiations at no additional cost.

Access to the Clinic's or Health Center's Account

The billing service should allow the clinic or health center to get full and secured access to their account anytime. They should also give full access rights where one can, for example, look up all patient accounts and print reports. In addition, a billing company of good repute will prepare and send frequent patient statements, for example every fortnight.

Reputation of Quality Customer Service

The billing company must have excellent customer service. It should be accessible on phone or have a turn-around time of less than 2 hours when responding to an email or phone call. Preferably, it should provide one team leader or contact person to handle the health center's or clinic's account.

3 Trusted Providers of OB/GYN Billing Services

OB/GYN practices involve a lot of billing-related hiccups to get paid (on time) for medical treatment and services provided. Sometimes insurance carriers can underpay an OB/GYN clinic for the services offered. In other cases, patients of the practice are slow to make medical billing payments on time.

The financial strength of one’s OB/GYN practice is directly linked to timely medical billing and reimbursement of accounts. It is essential for any provider of OB/GYN services to work with a professional billing company for quick follow ups and timely filings. However, OB/GYN practices that need to make a choice of a good billing company can find such a search an overwhelming task. Here is a compilation of the top three trusted providers of OB/GYN billing services.

1. Practice Management

Practice Management has been offering unmatched OB/GYN medical billing services since 1995. They have served a broad range of physicians and with reliable billing solutions to aid them to operate more efficiently and effectively. They are updated with revised and new CPT codes, E & M codes, and modifier codes and much more. They can also replace the non-payable or codes that have become obsolete with new ones.

Practice Management is equipped with highly educated and trained staff that is adept in offering a broad range of medical procedures such as pap tests, pregnancy and related complications, endometriosis, and complications related to vaginal mesh. What makes Practice Management unique is the use of advanced state-of-the-art technology. All their practices are geared towards improving revenue for OB/GYN clients as well as improving patient satisfaction. A combination of experienced staff with the trusted technological equipment places Practice Management ahead in OB/GYN practice. Moreover, Practice Management also provides credentialing and consultation services to physician billing clients.

2. Medical Practice Management Resource Incorporation (MPMR)

MPMR is another expert provider of OB/GYN billing services. Their state-of-the-art billing services have translated to excellent reporting and reliable client support services. Medical billing codes for obstetrics and gynecology are very complicated, and slight mistakes can cost someone thousands of dollars. Every single character in the code creates characters that appeared before it. This help in providing a unique code combination that shows the insurance companies the full description to ensure that they offer a standardized billing.

MPMR is equipped with competent staff that is rich in medical OB/GYN billing skills. They serve all clients whether new or old in OB/GYN billing field. Perhaps, they have helped a broad range of clients come out of the serious pitfalls in medical billing. They also have excellent customer support to aid one to get maximum revenue flow.

3. Dr. Billing Service, Inc.

Dr. Billing Service, Inc. has years of experience in providing excellent OB/GYN billing. They have been rated a five-star billing company due to the quality of services they provide. What makes Dr. Billing unique include the comprehensive OB/GYN billing services that they offer. The medical billing company offers a robust computer systems and software that are all designed for OB/GYN medical billing and collection. They also boast of their certified professional coders that work to ensure that clients get maximum reimbursement services. In their service line, they have also included AR and full electronic claims.

Dr. Billing makes everything out right by availing the necessary resources to ensure that clients get paid. Before setting out, they offer an initial evaluation. All the claims are submitted electronically hence reducing instances of fraud and errors. There are also detailed reports at the end of every month. It is their goal to ensure that clients get the highest returns on their claims while not sacrificing services on patients.

Top 3 FQHC Billing Companies in Review

For over 50 years, Federally Qualified Health Centers or FQHCs have been providing quality and comprehensive primary health care services to deserving citizens across the US. One of the major challenges that FQHCs have faced over the years involve effective and efficient billing, and getting patients to fulfill their medical bills in a timely manner.

To help FQHCs establish an effective and efficient billing systems and comply with all legal requirements when it comes to billing, most FQHCs outsource these functions to FQHC billing companies. The value in working with an FQHC billing company has led to the growth of numerous FQHC billing service providers around the US. With many FQHC billing companies available, it might be difficult selection the best one. Here is a review of some of the top three FQHC billing companies.

Practice Management

With several years of experience in the health sector, no other firm can match the level of professionalism and service provided by Practice Management. Know for being the best FQHC billing company in the US, Practice Management has helped numerous health centres streamline their billing process to improve revenue and payment turn around.

They mainly specialise in improving revenue collection efficiency and to this end have developed custom revenue management solutions for each of their clients. They have also developed software programs that help health centres be able to see all patient details and billing history. This is important in enabling a seamless workflow in the billing process and enhancing efficiency.

Practice Management is a reputable FQHC billing service company and offers specialized services in pediatrics, family practice, cardiology, internal medicine and numerous other areas. Practice management has expert and experienced staff who offers professional services in FQHC billing and other essential services like helping their customers comply with all FQHC legal and ethical regulations.

One other advantage that Practice Management offers is its professional team of customer service representatives who are bilingual and able to respond to any query or clarification that one seeks. You can get more information about FQHC billing company at MaximizedRevenue.com.

Visualutions

Visualutions is one of the top three FQHC billing service companies. In addition to providing normal FQHC billing services, its main specialization is in providing health centers with overhead cost reduction and revenue maximization solutions. To achieve this, Visualutions concentrates on staff training to equip staff with knowledge and skill to effectively manage FQHC billing services. They offer both classroom and hands on practical training.

Synergy Billing

Synergy billing is one of the top FQHC billing providers that has been in operation for several years now. In fact, it has been rated as being the best biller in terms of collection rates. Besides offering billing services that aim to maximise revenue collections, Synergy also offers FQHC staffs training to enable billing staff understand how FQHC billing system works. This aims at reducing over reliance on FQHC billing companies. Synergy also have regular informational webinars with FQHC staff to enable them maximize revenue collections.

Synergy also specialise in account receivable recoveries for FQHCs as they diagnose the problems resulting in A/R balances and follow up on each open account.

Effective Medical Billing Strategies to Increase Healthcare Reimbursements

It is an undisputed fact that the healthcare reimbursement system (as it is) can be described as brutal. The present set of processes and rules that some payers and insurance companies have put in place are not only complex but also confusing. This leads to the emergence of other problems like underpayments, denials, ignored or at times lost claims.

This has hugely contributed to issues when it comes to paying doctors in time as well as medical practices getting the revenue they generate in full.

This begs for there being in place effective strategies and insights that will help medical practitioners and health centers to improve their patient billing processes. This will help them generate more revenue as well as increase their healthcare reimbursements.

Use of Technology

Whenever a medical practice realizes that a claim is not paid for when they submit the claim for the first time, they should brace themselves that it will not be paid. In order to escape losing out on claims like this, the practice has to find ways that will help it establish potential denials before even submitting their claims. Medical practices could be able to achieve this feat by incorporating software in their systems that is capable of identifying claims with a high probability of being denied automatically.

This billing software utilizes an engine that is intelligent and one that adapts and updates itself constantly thus helping practices to stay informed and alert about denial trends that are latest in as far as claims are concerned. This will greatly improve the rates at which practices collect their revenue. This software is generally able to help the practices improve on the speed at which they collect, decrease the need of having in-house staff as well as increase first pass resolution rates.

Tackling Underpayments

Payer underpayments are another issue that keeps medical practices from collecting their full amounts of revenue. This is largely due to the different individual contracts doctors often enter into with different payers. Underpayments are far too common in situations for health center billing, specifically federally qualified health center billing (FQHC billing), as these community health centers are focal to serving low income patients who utilized Medicare and Medicaid.

This is the key reason why medical practices receive different amount of monies from the different payers. This makes it hard for the practice to keep track of the payments and hence making it even harder for them to realize when they are being underpaid.

It is for this reason that practices ought to turn to using medical billing software that is able to compare the payments it is receiving against the figures agreed to in the contracts automatically. This will largely cut short the number of payer underpayments scenarios. It will also increase the net collection rates, increase organization and efficiency of the practice and make it possible for the practice to forecast its collections in future.

Reporting

In order for a medical practice to realize its position as far as payer payments and collection rates are and the areas that need an improvement, reporting ought to be embraced. This can be done with software that is capable of allowing scheduled reports on the practice to be done at defined intervals.

This will give the practice the opportunity to have certain reports in an instant whenever it is needed. These reports make decision making easier, increase productivity (as it reduces staff requirements and make it easier to spot payer underpayments and other mistakes.

All the above solutions will ensure that your practice is able to collect more revenue thereby turning them into more revenue generating practices. They will also ensure that the practice increases its healthcare reimbursements. It also makes the collection of monies owed to the practice easy, fast and efficient.

For more quality information on how medical practices and health centers can improve healthcare reimbursements, visit MaximizedRevenue.com

5 Business Strategies to Make Your Surgery Practice More Successful

As a surgeon, you do not undergo business training during your time in medical school but you need it for a successful private practice.

Most surgeons and medical professionals have learned business strategies the hard way through an “on-job” sort of training. Below are five business strategies that will when implemented will make your surgery practice more successful.

1. Optimize your website 

With the ever-changing technology, everyone seems to turn to search engines when looking for information about products and services. There is no better way of getting the attention of people who may be looking for your services than through SEO for surgeons. Apart from listing your services and location on the website, you can come up with a blogging series.

Consider crafting a themed series that targets your client’s needs and provide them with an exclusive proposition. The information on your blog posts will give the visitors confidence in your services as well as build you image and brand.

2. Develop video content

Over the years, use of video content has massively gained popularity though it is not used by many organizations. Good and quality videos will help give your target clients a better insight of your services and the persona of your business.

In the videos, you can include tours of your facility to show clients your team of employees as well as the technology you use. You can also have interactive webinars with past clients to ask about their progress or with potential customers to answer their questions. Including the videos on your site will enhance search engine ranking and put out your business to more customers.

3. Embrace different social media platforms

Most internet users belong to at least one social media platform, the most common ones being Facebook and Twitter. It is advisable that you create a profile for your business in each of these platforms and engage your followers in discussions about your services. You can also create campaigns and give rewards to winners. You may decide to give a free service to whoever wins; such campaigns will get more people asking about your services.

You should also consider joining LinkedIn where you can join groups to get ideas of how you can improve your brand. It also gives you the opportunity to market your services to potential clients by contributing in discussions. Lastly, check out the emerging social media platform Google+. Between the four latter mentioned social networking sites, not only can you expand the visibility of your surgery practice, but these social media platforms have been proven to help support SEO strategies for surgeons and other business professionals.

4. Be patient-centered

At the end of the day, it is your patients who determine how successful your business becomes. If they give other people a positive feedback regarding your services you will get more clients.

Always help the patient go through what to expect from the procedure, its risks, and after-care. Do not just clear a patient for a surgery just because you need the money. After a surgery always ensure to follow up with your patients and find out how they are fairing.

5. Improve surgery billing process with patients

At the end of the day it is every business’s goal to make revenues. You therefore need to have a clear understanding of your revenue cycle. You staff should play a big role and ensure that billing starts immediately a patient makes a booking through to the time they are treated and discharged.

As surgery billing best practices, always ensure that the data obtained from patients is accurate so you are easily able to follow up on issues such as insurance and demographics. For maximum revenue it is critical that all charges are reconciled and above all make it a point to share your billing policies with clients.

Branding is critical in setting the tone on how your community and patients perceive your services. Using these five strategies will get your business rolling towards success.

Practice Management Now Offers Medical Billing Services for OB/GYN Clinics

The highly reputable medical billing agency, Practice Management, is exciting to announce that it will now be offering specialized billing services for OB/GYN Clinics. The company provides efficient physician billing services that help clinics to accurately bill their customers while staying compliant with all Local, State and Federal rules and regulations.

These systems are well designed by highly knowledgeable professionals, so they are ideally suited to the billing needs of the average OB/GYN clinic. Practice Management has many years of experience and they are dedicated to providing the best possible medical billing services for their client.

In addition to providing billing services for OB/GYN practices, they also have experience providing billing services to dermatology clinics, family practices, electrophysiology clinics, cardiology clinics, allergy billing, gastroenterology billing, surgery billing, health center billing and much more.

What Do the OB/GYN Billing Services Entail?

The OB/GYN billing services offered by Practice Management are designed with the best technology resources on the forefront of medical billing. These services include telephone and video conferences, electronic data transmission and web portal access to programs. This means that an OB/GYN practice will be able to remotely access its data so that it can perform all billing as seamlessly and efficiently as possible.

Practice Management strives to stay up to date on billing information, including new modifier codes, CPT codes and E&M codes. The billing services are able to provide for a number of medical procedures, including Pap Tests, Pregnancy treatments, endometriosis and complications of vaginal mesh.

These billing services have been custom developed with an OB/GYN practice in mind, so that they can provide the most advantageous features and the highest level of convenience. Any OB/GYN clinic will find these billing services very convenient and will enjoy the benefits of saving time and being more organized.

Value Offered to OB/GYN Clinics

By using the medical billing services offered by Practice Management, OB/GYN clinics will be able to operate their practice more effectively and efficiently. The system also allows for follow up billing services, so that clinics can improve their revenue cycle management.

Proper credentialing is very important for receiving accurate reimbursement. The Practice Management system offers Complete Credentialing Service and handles NPI and CAQH updates and applications. They are able to track the progress of each enrolment through completion.

Practice Management also offers a lot of value by providing their clients with individualized consultation services upon request. The talented consultant team is able to take a close look at the current operations of the clinic and provide an analysis. They will recommend changes you can make that will ensure your billing system is more efficient.

The goal of Practice Management is to provide each of their customers with the best possible OB/GYN billing solutions. They invest their ample resources and experience in order to achieve this goal, so that they can help their clients obtain the highest possible return on their medical billing claims. They have worked hard to develop a medical billing system that is as efficient, intelligent, versatile and accurate as possible and they are proud to offer this service to OB/GYN clinics.

The Business Behind Starting a Medical Practice

The prospect of establishing a health and medical practice business model can be brightened or dimmed by the nature of the market, the ingenuity of the entrepreneur, levels of capitalization, and other commercial dynamics. Renowned entrepreneurs in the health and medical fields achieved their successes on account of their exceptional strategies born out of their devotion to offer quality health services at a profit.

One of the most important factors to consider before starting a health and medical practice is the type of services to be offered. Experts in healthcare entrepreneurship usually begin by considering the range of services in order to determine the level of capitalization required. Moreover, drawing such limits helps in deciding the amount of space required and the type of equipment to be purchased. At the onset, the entrepreneur should enlist professional help in designing workflow processes.

Keeping Patients' Records Organized & Accessible

Record keeping is a core process in healthcare entrepreneurship. Inappropriate handling of patients' information can compromise the quality of service and expose both the patients and the institutions to significant inconveniences. The records may include information on the dates of admission, discharge, type of care, demographic identities of the patients, and other details that appertain to their needs.

Such information is necessary for future references or for making referrals, as some situations might require. It is advisable for healthcare entrepreneurs to hire experienced professionals to lay grounds and undertake the process of record keeping.

Medical Billing Solutions: Challenges and Options

In the opinion of many experts, medical billing remains one of the most challenging processes in healthcare institutions. The challenge is common to both established and new institutions, but new units are more likely to encounter the severest kinds of billing problems. Delays and human errors are some of the most common billing problems that afflict newly established medical businesses.

In times of an influx of patients, many healthcare and medical institutions encounter problems of billing the patients in a timely manner. Because of this shortcoming, some institutions have chosen the alternative to outsource medical billing services to a professional provider. Established outsourcing firms rely on automated billing solutions that lower the levels of susceptibility of the system to errors. Also, many medical billing providers specialize in certain forms of billing for specialized practices. For instance, a surgical practice should seek a company with expertise in surgery billing, while a Federally Qualified Health Center (FQHC) can find firm that specializes in FQHC medical billing solutions

Accounting & Financial Upkeep

Primarily, a health and medical enterprise is established with the objective of making profits. As such, the accounting processes of the business should be managed with utmost professionalism in order to show the financial health of the institution, from the moment of capitalization to subsequent business processes.

The role of accountancy within the firm should be conducted in accordance with applicable international standards regarding the treatment of operational expenses, cash flow, profits and losses, revenues, and all other financial processes within the firm. The institution's ledgers, cash book, and other important records must be updated with professional discipline.

Marketing & Reputation Management

Once a health and medical institution is established for commerce, it becomes necessary for the managers to employ the most effective marketing strategies that can guarantee a competitive edge and elevate its reputation. Like any other field of business, commercial healthcare is highly competitive as investors continue to invent result-oriented marketing approaches.

In order to enhance the chances of success, it is advisable for the management to rely on a combination of conventional and modern marketing strategies. Surveys have shown that conventional marketing processes such as print and electronic advertisements can enhance the market reception of a new business venture when combined with modern marketing strategies such as social networking and content marketing.