Wisely Choose Your Orthopedic Billing Partner

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Wisely Choose Your Orthopedic Billing
Partner
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Wisely Choose Your Orthopedic Billing Partner
Outsourcing is the Need of the Hour   Nowadays,
most of the practices feel comfortable passing
the burden of billing and coding onto medical
billing partners. Billing companies have medical
specialty-wise billing and coding experts who
streamline the revenue cycle process for
healthcare practice. But not all medical billing
companies are the same, some of them may not have
RCM experts or processes. Choosing the wrong
billing service or outsourcing for the wrong
reason can quickly become a risk and lost revenue
nightmare. Hastily outsourcing billing and
collections without careful evaluation of the
company could lead to severe problems in long
term. Performing due diligence before signing a
contract with such companies can mitigate risk
and performance issues before they become
unmanageable. Consider this article, as a guide
to choosing your orthopedic billing partner.
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Wisely Choose Your Orthopedic Billing Partner
Wisely Choose Your Orthopedic Billing
Partner Business Associate Agreement
(BAA) Fewer service rates are the only selection
criteria of most orthopedic providers. Many small
medical billing companies process a claim but
they are unaware of the regulatory environment or
the insurance compliances. Such billing
companies have no privacy, security, or document
destruction policies, and may not even know what
a Business Associate Agreement (BAA) is, let
alone supply one to the practice. When you are
entering into a contract with medical billing
company ensure that your BAA includes, a security
policy, a privacy policy, and have a breach
notification procedure in place and ready in case
a breach occurs.
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Wisely Choose Your Orthopedic Billing Partner
HIPAA and PHI Medical billing has been widely
affected since the HIPAA Omnibus Rule was
introduced in 2013. All parties involved in
managing patient health information (PHI) are now
required to have rigorous privacy, security, and
breach procedures. Practices should draft and
scrutinize the BAA carefully and ask specific
questions about the security policy for
electronic communication. Note that, if the
billing service doesnt shred accounts
receivable reports or paper Explanation of
Benefits, and these fall into the wrong hands,
the practice may still get fined. The billing
services security policy should cover the
details of protecting both digital and paper
personal health information (PHI).  Practices
should check about privacy policies and
procedures in the billing company.   Who has
access to confidential patient data and for what
reason? Do employees use computer privacy
screens? Do electronic systems log people off
after approximately 10 minutes of inactivity?
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Wisely Choose Your Orthopedic Billing Partner
Billing Expertise Dont assume that the billing
companys employees have up-to-date knowledge of
coding rules or Federal regulations. To provide a
more economical deal, billing companies might
assign lesser experienced billing experts for
your account. Billing companies might fall short
when it comes to training. Employees dont attend
annual society coding workshops. Their employees
may rely on years of experience and advice from
online coding discussion boards. An uneducated
workforce is dangerous. If billing service
employees are not receiving ongoing education,
they may not know regulatory rules or use best
practices for managing accounts. The billing
service employees should attend coding courses
each year. Practices should also expect the
service to be competent with ICD-10 coding and
aware of fraud and abuse statutes.
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Wisely Choose Your Orthopedic Billing Partner
Billing Reports You should ask for various
billing reports which give an overall picture of
your collection activities. To determine whether
the service uses effective accounts receivable
processes, orthopedic practices should ask how
unpaid, underpaid, and denied claims are
handled. Ask for AR aging, rejections, payment
trends, and overall collection report. Reputable
billing companies have procedures for every
medical billing process. Request copies of
billing and collections procedures, and sample
reports. Ask for protocols describing how credit
balances, refunds, and adjustments are handled
and modify these procedures for your practice.
You also need to clarify that the service will
never change a diagnosis or procedure code for
any reason without physician approval.   Before
outsourcing orthopedic billing and coding
services, practices should carefully evaluate the
billing company to minimize risk and lost
revenue. Medical Billers and Coders (MBC) is a
leading medical billing company providing
complete medical billing and coding services.
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Wisely Choose Your Orthopedic Billing Partner
Our HIPAA-compliant billing services, industry
presence of 15 years, and a team of
industry-best coders and billers make us a
trusted orthopedic billing partner. To know more
about our orthopedic billing services, contact us
at 888-357-3226 or drop an email
at info_at_medicalbillersandcoders.com. FAQs 1.
Why should orthopedic practices consider
outsourcing their billing? Outsourcing billing
can streamline the revenue cycle process,
allowing practices to focus on patient care.
Specialized billing partners have expertise in
managing complexities specific to orthopedic
billing and coding. 2. What should practices
look for in a medical billing partner? Practices
should evaluate a potential partners experience,
compliance with HIPAA, and the existence of a
Business Associate Agreement (BAA). Its
essential to ensure they have robust privacy and
security policies in place.
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Wisely Choose Your Orthopedic Billing Partner
3. How can I ensure my billing service is
knowledgeable about coding and regulations? Confi
rm that the billing companys staff receives
ongoing training in coding and stays updated on
federal regulations. Ask about their attendance
at annual coding workshops and other educational
opportunities.   4. What type of reports should I
request from my billing partner? Request
comprehensive billing reports that provide
insights into accounts receivable, claim denials,
and payment trends. This helps gauge the
effectiveness of their billing processes and
collection activities. 5. How can I protect my
practice from potential data breaches? Ensure
the medical billing company has a clear security
policy for managing patient health information
(PHI), including breach notification procedures.
Verify how they handle confidential data and what
access controls are in place.  
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