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Hospitals across the United States deal with over a thousand insurers daily, each having its individual requirements & plans. Hospital billing services play a vital role in helping hospitals handle their medical billing.
Hospitals have the difficult task of providing the finest treatment available to the public while still satisfying income generation requirements. Healthcare claims are generated to bill payers for the healthcare services rendered by medical providers & hospitals, including both outpatient & in-patient services.
The payers are also billed for the medical facilities provided such as laboratory tests & usage of special medical equipment. Efficient hospital billing services boost a hospital’s healthcare revenue cycle by ensuring that all necessary claims are billed.
Our certified medical coders reduce coding errors and maintain the highest level of accuracy. With our hospital billing services, you won’t have to worry about submitting clean claims. We carry out professional training for our coding team to make them aware of the latest changes and updates in the industry. This helps with reduced denials and also a fast flow of revenue for our clients.
Our hospital billing services process starts from the moment a patient schedules an appointment with your hospital. After scheduling an appointment, the patient must register with your hospital.
If a patient comes to your hospital for the first time, your administrative personnel will gather their demographic information. If the patient has already visited your hospital, you most certainly have the demographic information. After following confirmation that a patient's information is on file, the patient will indicate the purpose of their visit, which is then documented by your staff.
Upon receiving a patient’s insurance information, a medical biller determines the healthcare services that are covered by the patient’s insurance plan. Insurance coverage varies from person to person depending on their plan and insurance provider.
It is imperative for the biller to confirm every patient’s insurance coverage for billing them appropriately. If any services are not covered by the patient’s insurance provider, it is vital that the patient is aware of any charges they will have to incur.
Upon receiving a patient’s insurance information, a medical biller determines the healthcare services that are covered by the patient’s insurance plan. Insurance coverage varies from person to person depending on their plan and insurance provider.
It is imperative for the biller to confirm every patient’s insurance coverage for billing them appropriately. If any services are not covered by the patient’s insurance provider, it is vital that the patient is aware of any charges they will have to incur.
When a patient arrives at a hospital the front desk asks them to fill out a few forms to collect personal and insurance information. They are required to provide proof of identity, such as their insurance cards and driver's license. This is known as the check-in procedure.
When a patient checks out of the facility, their medical report from that visit is forwarded to a medical coder. The coder analyzes & reviews clinical documents to translate the services delivered into a diagnosis and billable procedure code. A superbill is prepared and subsequently delivered to the medical biller. This is known as the check-out procedure.
Upon a patient's check-out, the medical biller takes the superbill and prepares a claim that includes the patient and provider's information, the description of the services provided, & the amount to be paid by the payer.
After creating a claim, the medical biller must ensure that it meets all basic requirements and standards of billing compliance as laid out by the Health Insurance Portability and Accountability Act (HIPAA).
After making sure that the claims created meet the necessary compliance standards, medical billers submit their claims to the payer or a clearinghouse.
The insurance payer evaluates and reviews the claim to ensure its compliance. Whether the claim will be approved or denied is based on this. An accepted claim is paid by the payer, whereas a denied claim is refused. This claim should be then revised and resubmitted for reimbursement.
If a claim is approved, the payer will decide how much of the claim's cost will be refunded. Following this, the medical biller will receive a report outlining, that how much of the claim they will cover. It may also include an explanation for why a particular claim was refused.
A statement for the patient is generated which details the services that have been covered by their insurance provider & the portion of the cost that the patient is required to pay.
The medical biller must ensure that the patient pays for the treatments which their insurance company did not cover. If a patient fails to pay the remaining balance by the due date, the case may be turned over to a collection agency. Our hospital billing services help you navigate complex regulations for accurate claims and timely payments.
Our hospital billing services include verifying patient insurance eligibility, submit billing claims, and ensure your hospital gets fully reimbursed for inpatient and outpatient services. We offer comprehensive solutions to solve the billing needs of your healthcare organization and process claims from beginning to end, so you no longer need to manage or pay a billing department. Trust our expert team for optimal financial health for your hospital.
Medical billing is a complex job, and our hospital billing services are designed to simplify the process with accuracy. We have specialized teams who hold specific certifications to handle your billing and compliance management. Our Billing experts are knowledgeable and are responsible for the submission of the right claims to insurance companies. We believe in meeting and exceeding the industry standards without reducing the quality of our services.
We are a HIPAA-compliant hospital billing company. Our team follows all HIPAA regulations, including superior documentation, well-defined processes, and regular audits.
Frequent training keeps our coders and billers up to date on the continuously changing guidelines of regulatory authorities in the industry and other insurance payers.
We conduct routine claims audits to identify faults in existing systems and eliminate them to guarantee full reimbursements.
We ensure excellent accuracy levels through a multi-level quality check process for each essential component of hospital billing.
To ensure continuous cash flow, we rely on excellent technology such as Athena, Brightree, WebPT, and AdvancedMD to expedite hospital billing services.