Full Service Billing
Ever since the Health Insurance Portability and Accountability Act (HIPAA) was passed back in 1996, the entire healthcare industry has been moving towards a “paperless” environment to eliminate the billions of dollars of waste generated each year due to administrative overhead. Insurance companies, clearinghouses, and software vendors have all been enhancing their systems to meet the requirements mandated under the HIPAA law.
Providers are being asked to understand and adapt to all of the changes that affect them, such as privacy and security requirements, the implementation of new code sets (ex: ICD-10), and anything that affects the electronic submission of their claims (ex: ANSI 5010).
This move to a more streamlined, “paperless” environment has made everything more technical and requires providers to be more computer savvy than ever before. There are so many steps now involved between a provider treating a patient and subsequently getting paid that it can often become very overwhelming and time-consuming. If a provider does not have a good system in place to manage all of the necessary components of the medical billing process, it could affect their cash flow and lead to thousands of dollars being left in the pockets of insurance companies instead of their own. (This should NOT happen!)
Also of concern to many providers is the loss of knowledge attributed to employee turnover. Most providers either have an office manager or administrative assistant who handles their billing process. When these individuals leave a practice, the provider’s cash flow is at risk.
It should be easy for providers to get paid…plain and simple! But unfortunately, that’s not the case, and many providers leave a lot of money on the table because it’s just too difficult to deal with insurance. Many providers choose to write off those patient accounts they cannot reconcile instead of wasting their time with a less-than-helpful customer service rep who keeps giving them the run-around.
Because of these and other reasons, many providers decide to outsource their entire medical billing process to a billing service like us. By outsourcing to a third-party entity, a provider will no longer have to worry about keeping up with all of the industry changes that affect their practice or how their entire cash flow could suffer from the loss of one employee. Providers can now focus on treating their patients and leave everything else to Regal Billing.
How Does It Work?
- We can only work with practices who are using a cloud based EHR software package that we can access remotely.
- We will submit all claims for the practice.
- We will post all ERA’s returned to the clearinghouse and reconcile all claims that have been submitted.
- We will follow up and resolve any denied claims.
- We will run weekly aging reports to keep track of all claims that are still outstanding, and we will follow up and keep track of any claim issues that are causing delays in payments.
- We will communicate and work with the administrative staff of each practice to make sure the insurance billing process is running as efficiently as possible.
What Would Be Covered?
- Verification of Benefits
- Claims Submission
- Claims Reconciliation
- Insurance Payment Posting
- Follow-up and Resolve Denied Claims