FAQs based on recent webinar with Becky Ziegler-Otis, administrator at the Ambulatory Surgery Center of Steven’s Point, and Ann Geier, SourceMed’s VP Informatics.
What functions does a medical biller perform?
Billers are largely responsible for financial stability. Whether or not a facility gets paid can depend on how effective the biller is at submitting complete, accurate claims in a timely fashion. Some of the functions that medical billers perform include:
- Medical Coding by credentialed coders, who review information about the services that patients received and the procedures they underwent. They apply ICD9-CM codes (to describe the patient diagnosis), while applying ICD9-CM Procedures and CPT codes (to describe the services performed). They follow AMA coding guidelines to ensure there is no bundling, unbundling, or down coding. They enter all this into the medical billing software program.
- Reading and understanding EOBs (explanations of benefits).
- Following up on claims that have not been paid after 30 days.
- Reviewing denied claims and gathering information in order to appeal them.
How does a third-party billing company help with the high employee turnover rate among billers?
Continually recruiting and training medical billers wastes an organization’s time and money. This is not a problem, however, for medical billing services that handle the hiring and training themselves. Plus, having a large network of billers at their disposal ensures that no work is ever left undone – whether an employee is out sick, on vacation, or decides to leave the company.
How do experienced medical billers bring in more money to a facility?
Not all medical billers possess the same knowledge and skills – and one biller may not be capable of bringing in the same amount of money as the next. This can be due to a lack of experience working with a certain medical specialty, insurance company, or software. In comparison, working with a third-party medical billing company ensures that the people handling a provider’s billing processes have the necessary knowledge to get claims paid on time.
Read the full list of FAQs here