Wisely Choose Your Orthopedic Billing Partner

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Wisely Choose Your Orthopedic Billing Partner
Outsourcing is Need of the Hour Nowadays, most
of the practices feel comfortable passing the
burden of billing and coding onto medical billing
partners. Billing companies have medical
specialty-wise billing and coding experts who
streamline the revenue cycle process for
healthcare practice. But not all medical billing
companies are the same, some of them may not
have RCM experts or processes. Choosing the wrong
billing service or outsourcing for the wrong
reason can quickly become a risk and lost revenue
nightmare. Hastily outsourcing billing and
collections without careful evaluation of the
company could lead to severe problems in long
term. Performing due diligence before signing a
contract with such companies can mitigate risk
and performance issues before they become
unmanageable. Consider this article, as a guide
to choosing your orthopedic billing
partner. Wisely Choose Your Orthopedic Billing
Partner Business Associate Agreement (BAA)
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Wisely Choose Your Orthopedic Billing Partner
Fewer service rates are the only selection
criteria of most orthopedic providers. Many small
medical billing companies process a claim but
they are unaware of the regulatory environment or
the insurance compliances. Such billing
companies have no privacy, security, or document
destruction policies, and may not even know what
a Business Associate Agreement (BAA) is, let
alone supply one to the practice. When
you are entering into a contract with medical
billing company ensure that your BAA includes, a
security policy, a privacy policy, and have a
breach notification procedure in place and ready
in case a breach occurs. HIPAA and PHI
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Wisely Choose Your Orthopedic Billing Partner
Medical billing has been widely affected since
the HIPAA Omnibus Rule was introduced in 2013.
All parties involved in managing patient health
information (PHI) are now required to have
rigorous privacy, security, and breach
procedures. Practices should draft and
scrutinize the BAA carefully and ask specific
questions about the security policy for
electronic communication. Note that, if the
billing service doesnt shred accounts
receivable reports or paper Explanation of
Benefits, and these fall into the wrong hands,
the practice may still get fined. The billing
services security policy should cover the
details of protecting both digital and paper
personal health information (PHI).  Practices
should check about privacy policies and
procedures in the billing company. Who has
access to confidential patient data and for what
reason? Do employees use computer privacy
screens? Do electronic systems log people off
after approximately 10 minutes of
inactivity? Billing Expertise
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Wisely Choose Your Orthopedic Billing Partner
Dont assume that the billing companys employees
have up-to-date knowledge of coding rules or
Federal regulations. To provide a more economical
deal, billing companies might assign lesser
experienced billing experts for your
account. Billing companies might fall short when
it comes to training. Employees dont attend
annual society coding workshops. Their employees
may rely on years of experience and advice from
online coding discussion boards. An uneducated
workforce is dangerous. If billing service
employees are not receiving ongoing education,
they may not know regulatory rules or use best
practices for managing accounts. The billing
service employees should attend coding courses
each year. Practices should also expect the
service to be competent with ICD-10 coding and
aware of fraud and abuse statutes. Billing
Reports You should ask for various billing
reports which give an overall picture of your
collection activities. To determine whether the
service uses effective accounts receivable
processes, orthopedic practices should ask how
unpaid, underpaid, and denied claims are handled.
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Wisely Choose Your Orthopedic Billing Partner
Ask for AR aging, rejections, payment trends, and
overall collection report. Reputable billing
companies have procedures for every medical
billing process. Request copies of billing and
collections procedures, and sample reports. Ask
for protocols describing how credit balances,
refunds, and adjustments are handled and modify
these procedures for your practice. You also need
to clarify that the service will never change a
diagnosis or procedure code for any reason
without physician approval. Before outsourcing
orthopedic billing and coding services, practices
should carefully evaluate the billing company to
minimize risk and lost revenue. Medical Billers
and Coders (MBC) is a leading medical billing
company providing complete medical billing and
coding services. Our HIPAA-compliant billing
services, industry presence of 15 years, and a
team of industry-best coders and billers make us
a trusted orthopedic billing partner. To know
more about our orthopedic billing services,
contact us at 888-357-3226 or drop an email
at info_at_medicalbillersandcoders.com. FAQs
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Wisely Choose Your Orthopedic Billing Partner

• 1. Why should orthopedic practices consider
  outsourcing their billing?
• Outsourcing billing can streamline the revenue
  cycle process, allowing practices to focus on
  patient care. Specialized billing partners have
  expertise in managing complexities specific to
  orthopedic billing and coding.
• 2. What should practices look for in a medical
  billing partner?
• Practices should evaluate a potential partners
  experience, compliance with HIPAA, and the
  existence of a Business Associate Agreement
  (BAA). Its essential to ensure they have robust
  privacy and security policies in place.
• 3. How can I ensure my billing service is
  knowledgeable about coding and regulations?
• Confirm that the billing companys staff receives
  ongoing training in coding and stays updated on
  federal regulations. Ask about their attendance
  at annual coding workshops and other educational
  opportunities.
• 4. What type of reports should I request from my
  billing partner?

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Wisely Choose Your Orthopedic Billing Partner
Request comprehensive billing reports that
provide insights into accounts receivable, claim
denials, and payment trends. This helps gauge the
effectiveness of their billing processes and
collection activities. 5. How can I protect my
practice from potential data breaches? Ensure
the medical billing company has a clear security
policy for managing patient health information
(PHI), including breach notification procedures.
Verify how they handle confidential data and what
access controls are in place.