Medical Billers and Coders

  Physician Credentialing Physician credentialing is the process of organizing and verifying the professional records that qualify a doctor to practice medicine. As physicians, despite your reputation for benchmarked medical services, you could be losing out when it comes to realizing medical bills reimbursed fully by respective health insurance carriers. And when you start to analyze that elusive reason responsible for hampering your reimbursements, you invariably end up discovering ‘Credentialing’ as the chief culprit. Quite a contrast to the earlier scenario, wherein your credential as a qualified and competent practitioner could alone determine your practice’s sustenance and growth, the present-day scenario, characterized by innumerous practitioners and a heterogeneous mix of insurance carriers, requires your practices to bear the stamp of ‘Credentialing’ to stay well clear of audit, delay or denial exposures. Although physician practices are required to be credentialed by ...

  For you to improve the accounts receivable  (AR)  of your practice there are many different factors that come into consideration. Your quality of patient care is one such important factor that will contribute to attracting more patients. To improve the patient care for your practice things need to be systemized; we have to sync the work of an admin along with other patient-care factors. Healthcare providers lose millions of dollars each year due to inefficiencies in their accounts receivable (AR). Learn how to improve your AR days here. One of the easiest ways to achieve the complex goal setting of practice is to have a defined target and nothing can be better than an Account Receivable (AR) of a practice. A physician might say that yes I am seeing many patients but still my AR is low; one thing we ignore is the need for constant cash flow and collecting timely AR. Physicians often come out on a short end especially when they are dealing with bigger insurance compan...

  Provider-Based Physician Services Providers may retain physicians on a full-time or part-time basis in, for example, the fields of pathology, psychiatry, anesthesiology, and radiology, and in many instances (especially in teaching hospitals) in other fields of medical specialization as well. Any one of these physicians may be engaged in a variety of activities including teaching, research, administration, supervision of professional or technical personnel, service on hospital committees, and other hospital-wide activities, as well as direct medical services to individual patients. The provider’s arrangement may be with a single physician or a group of physicians who assume joint responsibility for discharging agreed-upon duties. Provider-based physicians may include those on a salary, or a percentage arrangement, lessors of departments, etc. (whether or not they bill patients directly). The services to the patient are known as the professional component. The services to the pr...

Physician billing, which is also termed  Ambulatory Surgical Center (ASC) billing  or professional billing is the billing of claims for services, which were offered or performed by healthcare professionals or a physician that also includes inpatient and outpatient services. In this blog, we will take a quick look at both physician and hospital billing. Majorly, these claims are billed electronically as the 837-P form. Institutional billing deals with claims for procedures or work executed by institutions like nursing facilities, inpatient and outpatient centers, and hospitals. Moreover, these claims need the 837-I electronic version or the UB-04 paper form. Institutional or hospital billing is basically more complicated and needs separate billers as well as coders. As far as physician billing is concerned, the role of billers and coders is merged many times. Nevertheless, when we emphasize medical billing and coding, one should specifically understand that physician billing se...