Medical Billing and Coding - Tips For Finding the Best Consultants

Medical billing and coding (MBC) involve an entire business model geared toward keeping medical records accurate and up-to-date in order to facilitate efficient revenue cycles. Revenue cycle management (RCM), also known as electronic medical billing (EMB) or medical billing software, is the electronic system used by health care facilities to manage patient care from initial enrollment and application to payment of a final balance. There are many benefits to implementing an effective revenue cycle management system for your business. These include reduced chance for medical errors due to human error, less need for time and staff resources to update patient information, and improved communication between physicians and patients.

As a medical facility expands and begins to experience more patients and increased revenue from each new patient, the need for efficient and reliable revenue cycle management becomes evermore prevalent. Medical billing and coding are the backbone of this management system, but without the necessary management systems in place, it is likely that the system will fail in some instances. Medical billing and coding service providers are an effective way to outsource the management of these tasks to experienced professionals who can take on this complex responsibility.

The first step towards outsourcing medical billing and coding to an outsourcing partner is to determine the scope of your healthcare operation. For small healthcare businesses, this can be as simple as determining how much revenue each individual patient contributes to the organization. This revenue includes direct costs such as equipment and supplies, as well as indirect costs such as facility rent and mortgage payment. The second step is to identify your current revenue management cycle. This cycle generally consists of three stages: appointment setting, primary care, and treatment administration. In most small healthcare businesses, this revenue management cycle is implemented on an individual basis, with the result that a substantial amount of time is wasted during the process.

Medical billing and coding specialists are often utilized as consultants by larger health systems. If you contract with a consulting firm that specializes in medical billing and coding, it is likely that they will provide you with the same level of expertise as they would for smaller healthcare operations. It is recommended that you contract with at least one consultant who has experience working with your size of business. The cost of employing this additional consultant can be significant, so it is important to consider the benefit of their increased productivity before committing to a long-term agreement. Medical billing and coding consultants can often save a large business thousands of dollars per year on unnecessary tasks.

Medical billing and coding consultants may be employed by independent agencies who provide training and certifications in medical billing and coding. If you choose to use an external service for your medical billing and coding needs, it is critical that you check their experience and credentials. While it is common for external services to advertise extensive experience, most will have little experience working with specialty insurance carriers. A thorough review of the company's client portfolio will help you evaluate their performance. You may also want to contact previous clients for information about their experiences with the agency.

The revenue cycle management capabilities of medical billing and coding consultants are an essential part of the comprehensive health information management strategy. The consulting firm will coordinate with your office, and work closely with your physician and other staff to ensure that patient access to vital patient information is efficient. Many physicians choose to retain a consulting firm because it eliminates many of the routine responsibilities that they may have had to address on their own. In most cases, the services of a billing and coding consulting firm are very affordable for small to mid-size offices.