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Are you sure your insurance companies are paying you according to your contracts? You may be surprised to know that it’s unlikely that they are. The average medical practice loses approximately five to ten percent of their collections because most insurance underpayments are never pursued or even identified.

The American Medical Association recently compiled a National Health Insurer Report Card for seven of the biggest payers in the industry — Anthem BCBS, Aetna, Coventry, Cigna, United Healthcare, Humana, and Medicare. Every single one of these payers failed to abide by their contracted payment rates to varying degrees.

The worst of the lot was United Healthcare, which failed to pay contracted rates in 38.4% of their cases. Cigna was the second-worst performer, underpaying 33.8% of their cases. Aetna followed at third place (29.2%), then Anthem BCBS (27.9%), Humana (15.8%), and then Coventry (13.3%). Even Medicare underpaid 2% of their cases.

Tracking these underpayments is tricky. If you watch many different medical practices, you’ll find the same CPTs receiving underpayments, at around the same deficiency, from the same payer, and around the same period of time. But after a month, you may find the payer playing the game with different groups of CPTs to avoid being spotted.

These under payments are not huge but they add up quickly to big dollars for a medical practice. The combination of switching the codes being underpaid from month-to-month and keeping the underpayment amount “under the radar” can make this difficult for an individual practice to spot.

Medical billing services may have difficulty finding these underpayments without comparing them with your contracted rates, as well as dealing with multiple procedure complications properly. Dealing with multiple complicated tables can be a challenge.

A medical practice or billing service must deploy and fully utilize the proper technology to systematically and effectively identify and pursue underpayments. Most billing systems do not allow effective management, identification and easy pursuit of underpayments. They typically fall short on at least one of these areas. Without the correct technology and supporting processes efforts to capture underpayments die under the complexity of the task.

Despite the complexity, however, it is worth solving this problem. Comparison of payments to allowables can increase a medical practice’s collections by 5 to 10 percent. This of course requires a strong process, powerful reporting technology and ability to track complex procedures methodically-in the end, it can however add thousands of dollars to your bottom line.

2009 copyright by Carl Mays II

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It’s hard to make sure insurance payers are issuing payments according to your contract. This is why it’s likely they’re not — it’s been found that medical practices typically lose about 5 to 10% of their revenue because of insurance underpayments.

A recent National Health Insurer Report Card compiled by the American Medical Association measured payment accuracy of seven major payers: Aetna, Anthem BCBS, Cigna, Coventry, Human, United Healthcare and Medicare. All of these payers to some degree strayed from contracted payment rate.

United Healthcare was the worst performer — it did not pay its contracted rates in 38.4% of all their cases. It was followed by Cigna, who didn’t pay the contracted rate in 33.8%, Aetna (29.2%), Anthem BCBS (27.9%), Humana (15.8%), and Coventry (13.3%). Medicare wasn’t a perfect performer either, underpaying 2% of their cases.

Tracking these underpayments is tricky. If you watch many different medical practices, you’ll find the same CPTs receiving underpayments, at around the same deficiency, from the same payer, and around the same period of time. But after a month, you may find the payer playing the game with different groups of CPTs to avoid being spotted.

On its own, an individual underpayment may not be significant enough to undermine a practice. But in the long-term, the cumulative impact of the underpayments can cost a medical practice thousands of dollars. Unscrupulous payers underpay different groups of CPTs every month, and keep the amounts underpaid small to avoid getting spotted.

It’s also hard for medical billing services to find when they don’t compare your payments to your contracted rates (as well as properly dealing with multiple procedure complexities). Properly maintaining and using more than one complex allowable table is difficult at best.

Any billing service (or stand-alone medical practice) needs to acquire and fully use industry technology to find and pursue underpayments. Most systems being used today are woefully ill-prepared to handle such cases — a good system should effectively manage, identify, and pursue these underpayments, but most systems fail in at least one of these areas. It’s a truly complex task that’s difficult to manage.

Despite the challenge, it’s still imperative to find ways to rectify the problem. Simply comparing payments to allowables can increase your monthly receivables by 5-10%. You’ll need a solid process, the latest in reporting technology, and a systematic way to track these procedures. Keep at it, and you’ll be adding thousands of dollars to your practice’s cash flow over time.

2009 copyright by Carl Mays II

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A recent Medical Group Management Association survey showed that medical practices utilizing medical billing companies typical see improved performance across multiple dimensions. The survey focused on practices that used medical billing companies instead of in-house billing solutions.

Here are some of the interesting facts that the survey revealed:

- 73 percent saw a reduction in their AR;

- 73 percent also received higher collection rates;

- 59 percent experienced fewer lost or denied claims;

- 59 percent enjoyed significantly better reporting and practice performance insights; and

- 46 percent enjoyed better productivity among staff.

The breadth of the performance improvements uncovered by the MGMA survey (with three quarters of all practices seeing significant performance improvements) adds fact-based credibility to the notion that a well selected and qualified medical billing company provides meaningful performance improvement for medical practices.

This is not a surprise since medical billing companies have several advantages over most in-house billing solutions:

1. Medical billing companies are often better-armed to buy and use technology to submit claims properly, deal with insurance companies, and collect on personal balances.

2. A medical billing company can attract a higher caliber of billing specialists and retain these individuals.

3. Billing services have a deeper bench of employees and this provides a layer of protection for your practice by decoupling you from the risk associated with losing a key (if not the key) billing employee.

4. Billing companies are better positioned to properly utilize the technology they have.

5. Medical billing companies deal with different medical practices and professionals, which gives them a much broader view of the industry than any single in-house billing department. This lets medical billing companies see trends in the industry that can help develop even better services in the long run.

If you’d like to see the survey for yourself, check the MGMA website.

Copyright 2009 by Carl Mays II

Before making your decision regarding a medical billing service be certain to visit ClaimCare’s Website. It provides in depth information about outsourcing medical billing. Carl Mays is a national renowned expert on medical billing operations and revenue cycle management.

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It’s official — a recent study made by the Medical Group Management Association (MGMA) has shown that medical practices and facilities that use medical billing companies experience improved billing performance over those that use in-house billing systems.

The study found the following advantages in employing the services of a medical billing company.

- Almost three in four practices that use medical billing companies reduce their AR;

- 73 percent realized higher collections;

- About three in every five practices have fewer denied or lost claims;

- Three in every five also reported better practice performance insights; and

- Almost half experienced better staff productivity.

The breadth of the performance improvements uncovered by the MGMA survey (with three quarters of all practices seeing significant performance improvements) adds fact-based credibility to the notion that a well selected and qualified medical billing company provides meaningful performance improvement for medical practices.

Of course, medical billing companies do present many advantages over many in-house billing solutions.

1. Medical billing companies are more likely to be able to buy and utilize industry technology, helping practices submit claims, negotiate with insurance companies, and collect personal balances more effectively.

2. A medical billing company can attract a higher caliber of billing specialists and retain these individuals.

3. Billing services have a deeper bench of employees and this provides a layer of protection for your practice by decoupling you from the risk associated with losing a key (if not the key) billing employee.

4. Medical billing companies also utilize industry technology better and more efficiently.

5. Medical billing companies have a broader view of the medical industry as a whole because they deal with many different medical professionals at the same time. This knowledge helps them deliver better services to their clients.

A copy of the survey is available from the MGMA’s website.

Copyright 2009 by Carl Mays II

Before deciding upon a medical billing service be sure to visit ClaimCare’s Website. It provides in depth information about outsourcing medical billing. Carl Mays is a national renowned expert on medical billing operations and revenue cycle management.

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A recent Medical Group Management Association survey showed that medical practices utilizing medical billing companies typical see improved performance across multiple dimensions. The survey focused on practices that used medical billing companies instead of in-house billing solutions.

The study found the following advantages in employing the services of a medical billing company.

- Almost three in four practices that use medical billing companies reduce their AR;

- The same ratio of medical practices experienced higher collection rates;

- About three in every five practices have fewer denied or lost claims;

- 59 percent enjoyed significantly better reporting and practice performance insights; and

- 46 percent achieved higher staff productivity.

The MGMA study found that more than three out of every four practices that employ the services of a good medical billing company enjoy impressive improvements in productivity and performance. This confirms the long-held notion that utilizing a medical billing company improves a medical practice’s performance.

This is not a surprise since medical billing companies have several advantages over most in-house billing solutions:

1. Medical billing companies have more scale to purchase and deploy the technologies required to properly submit claims, battle with insurance companies and collect personal balances.

2. A medical billing company can attract a higher caliber of billing specialists and retain these individuals.

3. Billing services have a deeper bench of employees and this provides a layer of protection for your practice by decoupling you from the risk associated with losing a key (if not the key) billing employee.

4. Medical billing companies tend to stay on top of developing industry technology better than in-house billing departments.

5. Medical billing companies have a broader view of the medical industry as a whole because they deal with many different medical professionals at the same time. This knowledge helps them deliver better services to their clients.

A copy of the survey is available from the MGMA’s website.

Copyright 2009 by Carl Mays II

Before deciding upon a medical billing service be sure to visit ClaimCare’s Website. It provides in depth information about outsourcing medical billing. Carl Mays is a national renowned expert on medical billing operations and revenue cycle management.

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Medical billing online gives you an opportunity to work from home. The downside of this work option is that there are quite a few online scams trying to sell you junk. The scams have become such a big pain, that even the Federal Trade Commission themselves nowadays sends out warnings about frequent scams in this field.

The most disappointing thing is, even the legitimate places may let you down. They assure you that they would assist you in finding the potential employers, and then merely provide you with a list of the health care providers, who may actually not even be interested in acquiring any medical billing services. It is must to do your homework, rather than hastily getting into some medical billing online course.

As far as medical billing online work itself is concerned, there are also a number of questions to consider, such as: Do you have any kind of knowledge of working in the medical field? Do you have any kind of knowledge of being your own boss? Will your perspective health care employers be willing to work with you right away, or would they necessitate that you first work for 1-2 years in their office, in order for them to get to know you and your skills?

Medical billing online is similar to regular paper medical billing, with the only difference of being online. As a matter of fact, the advance of Internet technologies has created numerous services which can be done from home. Many people prefer working from home instead of going to an office.

As a medical billing online professional you would be: organizing statements and bills and talking to patients and insurance companies (via email or phone). You must know how to encode and decode diseases, procedures, and billing statements. Furthermore, you will also be required to follow up on the failed payments, payment denials and refusals.

Medical billing online also requires entering the patients’ information into a special software application, installed on your personal computer. Coding of the procedures is stringent, and wrongful coding may cause various legal implications. As a result, medical billers have to be highly knowledgeable and skilled.

Larger medical billing online companies, are more appealing to health care providers. Where can you find your first job assignments? You can try freelance websites, where health care organizations post jobs for medical billers. However, there will be many other people competing for the same job.

Do your homework first to avoid disappointments in the future. Contact doctors and health care professionals to inquire if they would be interested in acquiring your services. Do it via phone or email, or even by visiting these professionals in their free time. The feedback you get from this exercise will help you decide whether it is worth it or not, whether spending thousands of dollars on medical billing online courses and specialized software would be a good decision or not.

In most cases, you will have to contact health care providers directly. Different means of doing this are: through job applications, emailing or calling.

How much can you make, working as a medical billing online service provider? Your profits will largely depend on the amount of work, which you are able or willing to take on. A full-time medical billing online professional can make anywhere up to $100,000.

Piper Wongeh has throroughly researched medical billing online and medical billing and coding industry.

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It’s official — a recent study made by the Medical Group Management Association (MGMA) has shown that medical practices and facilities that use medical billing companies experience improved billing performance over those that use in-house billing systems.

The survey found that for practices switching from in-house billing to a medical billing company:

- Almost three in four practices that use medical billing companies reduce their AR;

- 73 percent realized higher collections;

- 59 percent decreased the volume of lost/denied claims;

- Three in every five also reported better practice performance insights; and

- 46 percent enjoyed better productivity among staff.

The breadth of the performance improvements uncovered by the MGMA survey (with three quarters of all practices seeing significant performance improvements) adds fact-based credibility to the notion that a well selected and qualified medical billing company provides meaningful performance improvement for medical practices.

Some of the more obvious benefits of using a medical billing company include the following:

1. Medical billing companies have more scale to purchase and deploy the technologies required to properly submit claims, battle with insurance companies and collect personal balances.

2. A medical billing company can attract a higher caliber of billing specialists and retain these individuals.

3. Billing services keep a deep employee roster, giving medical practices the security that an in-house billing system can’t. For instance, practices using a medical billing company won’t face the risk of losing a key employee in the billing department.

4. Medical billing companies also utilize industry technology better and more efficiently.

5. Finally, medical billing companies have a broader scope than any single medical practice or facility. This allows them to see patterns across practices, specialties, states and payers that can add money to your medical practice’s bottom line.

If you’d like to see the survey for yourself, check the MGMA website.

Copyright 2009 by Carl Mays II

Before making your decision regarding a medical billing service be sure to visit ClaimCare’s Website. The site provides in depth information about outsourcing medical billing. Carl Mays is a national renowned expert on medical billing operations and revenue cycle management.

Bookmark It

It’s official — a recent study made by the Medical Group Management Association (MGMA) has shown that medical practices and facilities that use medical billing companies experience improved billing performance over those that use in-house billing systems.

The survey found that for practices switching from in-house billing to a medical billing company:

- 73 percent of practices using medical billing companies reduce their AR;

- 73 percent also received higher collection rates;

- 59 percent experienced fewer lost or denied claims;

- Three in every five also reported better practice performance insights; and

- 46 percent achieved higher staff productivity.

These and other findings offer factual evidence that the majority of medical professionals and practices that utilize well-chosen medical billing companies experience broad improvements in performance and productivity.

Some of the more obvious benefits of using a medical billing company include the following:

1. Medical billing companies are more likely to be able to buy and utilize industry technology, helping practices submit claims, negotiate with insurance companies, and collect personal balances more effectively.

2. A medical billing company can attract a higher caliber of billing specialists and retain these individuals.

3. Medical billing companies keep a deep bench of employees, so their clients don’t have to deal with the risk of losing a key billing employee from an in-house billing solution.

4. Medical billing companies also utilize industry technology better and more efficiently.

5. Medical billing companies have a broader view of the medical industry as a whole because they deal with many different medical professionals at the same time. This knowledge helps them deliver better services to their clients.

If you’d like to see the survey for yourself, check the MGMA website.

Copyright 2009 by Carl Mays II

Before making your decision regarding a medical billing service be sure to review ClaimCare’s Website. It provides in depth information about outsourcing medical billing. Carl Mays is a national renowned expert on medical billing operations and revenue cycle management.

Bookmark It

Medical billing online gives you an opportunity to work from home. The downside of this work option is that there are quite a few online scams trying to sell you junk. The scams have become such a big pain, that even the Federal Trade Commission themselves nowadays sends out warnings about frequent scams in this field.

In fact, even the legitimate sites may let you down, first assuring you that they will help you find the potential employers, and then merely providing you with a list of the health care providers, who may actually not be looking for any medical billing services. It is important to do your homework, and not just buy any medical billing online course.

As far as medical billing online work itself is concerned, there are also a number of questions to consider, such as: Do you have any kind of knowledge of working in the medical field? Do you have any kind of knowledge of being your own boss? Will your perspective health care employers be willing to work with you right away, or would they necessitate that you first work for 1-2 years in their office, in order for them to get to know you and your skills?

Medical billing online is the same as regular paper medical billing, but it is done online instead. With the advance of Internet technologies, there are now quite a few services which can be done from home.

As a medical billing online professional you would be: organizing statements and bills and talking to patients and insurance companies (via email or phone). You must know how to encode and decode diseases, procedures, and billing statements. Furthermore, you will also be required to follow up on the failed payments, payment denials and refusals.

Medical billing online will also require from you, to enter the patients’ information into a special software application, installed on your personal computer. Coding of the procedures is disciplined and rigorous, and wrongful coding may cause various legal implications. Due to these reasons, you have to be very well-informed and skilled.

Larger medical billing online companies, are more appealing to health care providers. Where can you find your first job assignments? You can try freelance websites, where health care organizations post jobs for medical billers. However, there will be many other people competing for the same job.

Do your homework first to avoid disappointments in the future. Contact doctors and health care professionals to inquire if they would be interested in acquiring your services. Do it via phone or email, or even by visiting these professionals in their free time. The feedback you get from this exercise will help you decide whether it is worth it or not, whether spending thousands of dollars on medical billing online courses and specialized software would be a good decision or not.

In most cases, you will have to contact health care providers directly. Different means of doing this are: through job applications, emailing or calling.

A very important point to explore is the kind of earnings you can expect as a medical billing online service provider? This depends upon the amount of work you carry out. A full-time medical billing service provider can expect up to $100,000 plus depending on the amount of work completed.

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When wearing formal wear try and match the colour of your cufflinks with the colour of your tie. Many designer brands produce matching sets, such as Duchamp-London. Its also appropriate to wear a cufflink made from semi-precious materials such as mother of pearl (ideal for weddings), onyx and haematite.

Simon Carter has a large range of semi precious cufflinks which are decorated with stones including sapphires. These cufflinks have a special flavour, as opposed to an everyday style made from perhaps coloured enamel. For the glitzy and glamorous social events, crystal cufflinks will add that extra bit of bling.

Whilst black and white crystal cufflinks is a classic look for a black tie event, multi coloured crystal cufflinks can add a bit of colour to an otherwise monochrome outfit. Cufflinks are quite a subtle accessory anyway, so they wont dominate your look.

Pochettes and dinner scarves are considered old fashioned and a bit over the top by many people. Very few men wear them anymore, so these accessories can act as a bit of a design statement and help you stand out from the crowd. A matching pochette and tie speaks of old fashioned sartorial elegance, a gentleman with a keen eye for detail.

It is also another opportunity to inject some life and colour into a suit. Admittedly not for everyone, it takes a man with a real self confidence to wear one. The leather belt should match your more dynamic look, which can be achieved through a more unique buckle such as a plaque or elongated design. Fashionable socks are also an integral part of a lively formal outfit, with stripes being particularly popular. If you can match up colour or pattern in all your different accessories then you are creating a cohesive and dynamic look for a formal social occasion.

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