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FACT: Medicare, MediCaid and most insurance companies are making it more and more difficult for healthcare providers to collect reimbursements!

With the introduction of NPI and HIPAA compliance most providers are being forced to comply and update their current process. Medicare and MediCaid are constantly changing their billing guidelines and modifiers. And you must keep up with these changes in order for you to receive the proper reimbursement that you are entitled to.

PROBLEM: Thorough follow-up is NOT done on denied claims:

Unfortunately, most medical facilities do not thoroughly conduct follow-ups when a claim is denied. Usually, they do not have enough staff, not enough time, or it’s too much of a hassle to follow-up on denied claims…which means unnecessary lost revenue to you, especially if the claim is denied due to clerical mistakes. If your rejection rate is greater than 5%, then sufficient follow-up is NOT being conducted.

Benefits of Using a ACP Billing

ACP - Medical Billing Services has many advantages. Instead of spending countless hours entering claims information, printing and sending forms, and waiting on hold with the insurance companies... that time could be used to update patient information, record keeping, or do better scheduling... as a result you can set more appointments... which means more money for your clinic. However, know that not all medical billing services are the same. You need a medical billing service that can not only get you your money, but do it accurately and on-time! The following are a few questions you’ll want to ask before you hire any medical billing service to make sure they can help get you paid accurately and on-time:

How much experience does this billing service have? Would you want to hire a company who is just starting out? Find out how many years the company has been in existence and test them on their claims processing knowledge.
Do they have any checks in place to control clerical mistakes that could lead to your claims being denied? Is it automated or manual?
Exactly, how many doctors are they currently servicing?
How big is their staff? What’s the combined number of years of experience?

Again, you’ll want to find out how experienced the company is with billing, especially with Medicare claims. Do they follow-up when claims are denied? If so, what is their procedure for following-up with denied Medicare claims?

Even if you’re not currently looking for an electronic medical billing company right now, knowing what questions to ask will help point you in the right direction when the time comes.