Why Outsource Medical Claim Billing?

Medical claim billing is a process of complete paper work submission and claiming by insurance companies for retrieving payments. This process generally followed by medical insurance companies which are private or government companies.

Medical claims invoice process involves various types of activities but the main purpose of any claim billing company is to process super-bills and submitting medical claims to insurance companies in order to receive payments for their clients in a timely manner.

Once the procedure and diagnosis codes are determined, the medical biller will transmit the claim to the insurance company. Medical claims invoice is usually done electronically by formatting the claim as an ANSI 837 file and using electronic data interchange to submit the claim file to the payer directly or via a clearing house.

To run a profitable medical business, hospitals and other health care facilities should follow an effective way of collecting reimbursement.

Medical claims invoice process includes the below steps:

- Pre-certification & Insurance Verification
- Patient Demographic Entry
- CPT and ICD-9 Coding
- Charge Entry
- Claims Submission
- Payment Posting
- Account Receivables Follow-up
- Denial Management

Today, invoice process is become one of the most important outsourcing services in the healthcare industries and across the world. This services booming day by day in many hospitals and practitioner to outsource their invoice and reimbursement requirements to offshore facilities.

The concept of invoice outsourcing was started from the requirements to get additional billing specialists to perform those secondary tasks apart from the primary medical tasks which are managed by the billing specialists from the medical institutions such as the hospitals, private clinics, nursing homes etc.

Outsourcing of medical invoice service has been widely implemented in the medical industry today. Offshore Medical Billing has provided numerous medical health care and medical billing services. We also provides medical invoice systems with more than 17 years of experience, specialized in services provided with Medicare and Medicaid.

To outsource your medical billing requirements to us, please contact us.

Corporate Health Insurance

Corporate health insurance is provided by most employers today to their employees. Corporate health insurance is usually part of the benefits package that employees receive. Such plans are meant to cover costs of necessary treatments and health care which are required by employees and their families. As the cost of health care and medical treatment is increasing, a large number of employers are scrapping corporate health insurance from their benefits list. This is generally true in cases of small businesses. Employers think that corporate health insurance for the employees is a waste of money, and these funds can be used in a more productive manner. However, they do not realise that such insurance is really important and will go a long way in decreasing employee turnover.

Corporate Health Insurance For Small Businesses

There are certain eligibility criteria that must be met before a firm can apply for corporate health insurance. One of the most important things is that the business has to be legitimate. The business can either be structured as a partnership, corporation or a sole proprietorship. If the business is a partnership business or a sole proprietorship, it should obtain a licence or should have filed for a fictitious name. Limited liability businesses and corporations should file articles of organization and incorporation.

There should be at least two employees working full time. The minimum number of employees in small corporations must be two and the maximum fifty.

Advantages of Corporate Health Insurance

Corporate health care insurance can be beneficial for the employers and also for the employees. If an employer or his family members require treatment or surgery, they will be covered under the plan. The same goes for employees. However, the employer also has the option of getting an individual medical insurance policy. In any situation, having a corporate insurance cover can be a life saver. According to the Federal Law, if any individual seeks coverage under a group, he will not be denied coverage regardless of his past claims history. On the other hand, the exclusion period for pre existing conditions cannot be more than 12 months.

The advantage of collective bargaining power is that the monthly premium will be low. Because of the members in the group, the employer also pays a small amount of premium. Since the employer contributes a small amount as monthly premium, it reduces his tax burden because insurance premium is tax deductible.

Alternatives

There are a large number of employers who cannot provide corporate health insurance to their employees. In such a case, they can opt for a health savings account which will be employee owned. HSAs or health savings accounts will be used to collect funds for future medical treatments. For example, if any employee suffers a medical problem later on, funds from this account will be used for his treatment. The employer can choose the amount each employee has to contribute monthly. Moreover, such a scheme also allows employees to choose their own health care insurance provider. Whether you choose HSA scheme or a corporate health insurance plan, both help reduce employee turnover and helps businesses save a lot of money that would be spent on hiring new employees.

Improvement Programs for Clinical Documentation

Clinics and hospitals are just some of the most common medical institutions which are expected to provide quality health care and medical services. They must have the goal of improving the efficiency of their daily operations which is something that can be achieved through clinical documentation improvement programs. These improvement programs are implemented to promote accuracy and quality on medical records which are the basis for having a more organized and systematic daily operations. They are also intended for developing better medical practices that will improve the quality of health care services and reduce human error. Since medical records are patient centric, they can be very hard to handle without effective practices. This is what improvement programs will try to target as new practices, tools and applications will be introduced.

Reducing human errors and improving the efficiency of a medical institution can be hard to achieve without the help of every personnel in a medical institution. This goal eventually leads to high standard medical services since of concerns can be resolved effectively. Documentation in the medical field can be very sensitive and demanding since huge amount of information has to be handled on a daily basis. Without a systematic procedure in handling medical records, everything else may fail and you may endanger a lot of lives. Furthermore, you will be exposed to potential liability suits and other legal issues. This will greatly affect the overall revenue of the institution and the motivation of all the members of the organization.

As medical institutions face the challenge of meeting the demands and needs of the patients, they are expected to observe standard quality of medical services. Their tasks may affect the lives of the patients involved so any careless decisions can lead to a lot of trouble to both the patient and the physician in charge. Things can become convenient by adopting modern tools and applications as suggested by the adopted clinical documentation improvement programs. The programs are designed to consider the current practices being used in preparation for the incorporation of new techniques. Most of these techniques involve software, programs, and applications designed to automate and effectively organize documentation.

Aside from increased profits for a medical institution, clinical documentation improvement programs can ensure liability free operations. This can give a good reputation to a certain hospital. Most of all, patients can enjoy the highest quality of health care and medical services characterized by their timely recovery.