Better Tips to Enhance Outsource Medical Billing and Coding Quality

Medical billing services have increasingly become an important component of the modern healthcare ecosystem. Equally important is the quality and efficiency of the service provider you choose. 

An optimized medical billing service system leads to better revenue generation and more efficient insurance claims. While there are in-house and outsourced systems, both with their unique merits, outsourced medical billing services often provide greater flexibility and cost-effectiveness.

Tips To Enhance Outsourced Medical Billing Services

Let us take a look at some of the ways outsourced medical billing services can be enhanced for improved efficiency.

Understand Claim Denial Patterns

Billing service providers must compile a monthly claim denial report and try to fish out specific patterns. These will help the coding team better understand the root cause of such denials and help remedy the problem. They can schedule and adhere to the Electronic Medical Record (EMR) workflow, manage tasks, view logs, etc.

Streamline The Documentation Procedure

Documentation is a crucial aspect of the overall billing system. It is noticed that many errors are made at the documentation stage, which eventually leads to claim denials or delays. However, with a streamlined documentation section, the coding process can be enhanced dramatically. 

Medical firms that struggle with documentation can consult a clinical documentation improvement (CDI) professional. CDI specialists are individuals who have prior knowledge of clinical and medical documentation, and with their input, you can transform the overall documentation process.

Incorporate HCCs and SDOH 

Hierarchical Condition Categories (HCC) coding can be an important tool for medical service providers to better gauge a patient's medical condition. It includes factors like age, gender, and health status, which can be used by coders to determine a person's expected healthcare expenses. 

Additionally, Social Determinants of Health (SDOH) incorporate factors like educational background, economic capabilities, and the social and cultural conditions of a person. With this added data, coders can assign specific ‘Z’ codes, which can be used as a determinant for present and future health.

Prioritise Data Security

One of the biggest drawbacks of outsourcing medical billing services is the lack of data security they provide. Oftentimes, sensitive patient data can be lost to security and data breaches, which can cause a sense of dissatisfaction among patients.

Modern medical billing services systems must make sure to incorporate all kinds of security measures, which will instill trust among customers. Some popular security measures companies can use include advanced data encryption technology, stringent access control, and regular audits.

Use Artificial Intelligence & Machine Learning

Artificial intelligence and machine learning can revolutionize the medical billing process. With the help of artificial intelligence, billing companies can eliminate human error. This will not only reduce the overall claim denial process but also reduce the overall cost of the procedure.

With AI, companies will not have to hire specialized personnel for the billing process. Alternatively, they can save on the cost of training as AI computers do not require special training.

Machine learning programs, on the other hand, can be used to learn the existing medical billing codes. They can not only optimize the entire process but also suggest improvements in the existing system.

How OmniMD Can Solve Your Medical Billing Related Issues?

Medical establishments, which tend to skimp out on quality coding and billing services, often run into insurance claim snags. This can lead to an increased number of claim denials and a loss of potential revenue.

OmniMD, based out of New York, is a healthcare IT company with 20+ years of industry experience. They specialize in providing services like all-in-one electronic health records (EHR), practice management (PM), and revenue cycle management (RCM) solutions for medical practices. Here is how it helps in your medical billing and coding.

Boosts Revenue

➔ Claim denials are a major stumbling block for medical establishments across the globe. With OmniMD’s advanced reporting tool, you can analyze the denial trend in real-time and better sort out the problem areas. OmniMD promises a 15% reduction in denials thanks to its targeted action.

➔ Hierarchical Condition Categories (HCC) combined with Social Determinants of Health (SDOH) represent the most important data related to patient health. However, integrating and using this data is easier said than done. OmniMD billing systems not only excel at making use of the HCC and SDOH numbers but also help predict patient health and ensures revenue maximization. 

➔ With OmniMD’s AI and machine learning optimization features, medical establishments can better omit human error from billing and coding. OmniMD promises 30% fewer errors and an optimized machine code, which eventually frees up staff for other tasks, boosting revenue for your medical unit.

Enhanced Efficiency and Security 

➔ OmniMD, with its intuitive EHR system, allows you to complete a paperless documentation procedure. It not only cuts processing time by 20% but also easily ties into overall coding compliance.

➔ OmniMD’s outsourced medical billing solution is an automated process. This means healthcare establishments can eliminate the dedicated billing team and shrink the overall staff size by 15%.          

➔ OmniMD boasts unwavering security related to sensitive patient data. A combination of advanced encryption, access control, and regular audits ensures complete data security and HIPAA compliance.

Addresses Common Medical Billing Software Problems

• Slow Billing: OmniMD's automated workflows and paperless documentation expedite claim processing times by 30%.
• Coding Errors: Eliminate coding errors with OmniMD's 100% coding compliance guarantee and real-time claim scrubbing.
• High Cost: Reduce staffing needs and administrative expenses with OmniMD's scalable and affordable solutions.
• Denial Management: OmniMD's dedicated denial management team handles appeals and maximises reimbursement recovery.

Other Features

➔ At OmniMD, we promise to handle the complete revenue cycle management system, including billing, eligibility verification, and claim submission, so that you can focus on the more important aspects of patient care.

➔ Our 24/7 support staff provides round-the-clock expert assistance to ensure smooth operations. 

➔ We at OmniMD offer scalable solutions that can be customized based on your needs and budget. Whether you are a small practice or a large healthcare establishment, OmniMD has the perfect solution.

Conclusion

To conclude, medical billing is an important procedure in the healthcare sector, with two different types of services available. Recently, outsource medical billing services has emerged as the go-to option due to its various advantages. 

When you choose to outsource medical billing services, ensure that the above-mentioned points are taken care of. With an efficient medical billing service provider, the healthcare industry and its consumers can immensely benefit in the long run.