Using certified medical billers saves physicians frustration while optimizing revenue cycle management. Their value in terms of highly accurate claim filings, successful appeals, and audit protection is well worth the investment for any medical practice.
1. Increased Reimbursement Rates
Certified medical billers have extensive training in CPT and ICD-10 coding. Their expertise in assigning accurate codes and including proper modifiers on claims can increase reimbursement rates by up to 15%. This additional revenue far outweighs the cost of their services.
2. Faster Payments
Claims filed by certified medical billers have higher first-pass acceptance rates thanks to strict adherence to latest payer guidelines. Clean claims mean faster payments and improved cash flow for the practice. This also allows for more timely billing of patient responsibility. This is extremely important as patients are increasingly more responsible for health care services. It is important to have good patient collection practices in place.
3. Appeal Success
When claims are denied, certified billers have the skills to file carefully constructed appeals backed by documentation. Their in-depth understanding of appeals processes results in overturning up to 73% of denials.
4. Audit Protection
In case of an insurance audit, certified medical billers serve as a line of defense against payment recoupment. They provide auditors with well-organized supporting paperwork and answer questions knowledgeably, minimizing financial losses.
5. Stay Updated on Regulations
Billing rules change frequently, and staying current takes vast amounts of time physicians lack. Certified medical billers dedicate time specifically to keeping up with latest compliance updates, guidelines, billing codes and payer policies.
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