Tuesday, February 9, 2016

There Is A Slow Down In Collecting Payments From The Insurance Companies

By Lonnie Greenfield

If you do medical billing for a living, you are probably scratching your head about the new ICD-10. It was released on October 1, 2015. There are many different techniques that you must use in order to get a good return from the insurance companies. Gone are the good old days of ICD-9. These codes were once easy to submit to the insurance companies. All you had to do was ask for reimbursement and you would often see a high return coming back to you. Now, medical coders are seeing a slowdown in the billing process. Many coders are seeing payments coming to them after 90 days. It is not uncommon for an insurance company to tell you that they need more information before releasing any money to you.

A lot of coders today are asking themselves if they should go back to school or if they should go for their certification. What should they do in order to receive payments? It is a hard choice for a biller to make? In the 1980's and 1990's, you could easily take a stay at home course. You could get a job after studying coding for around 6 months. Now things are a lot more complex. Medical billers must now decide on the best course of action to learn this material.

The reason why doctors lose money most of the time is because of incorrect medical billing. In order to get a higher return from the insurance companies, someone must know billing like the back of their hand. They must know how to bill the insurance company correctly. The war between doctors and insurance companies are going to get worse. Insurance companies know how to win over the doctors and not pay them because they are not filling in the paperwork correctly. A medical doctor must find an experienced medical biller if they are ever going to make money for their practice. It has gotten so bad that many doctors are choosing to leave their practice and work instead for a hospital. At the end of the day, it all comes down to money.

The important functions of a medical biller today are that you need to be open to change. It is important for a medical biller to know a lot about anatomy and working directly with a medical doctor. Those that choose not to work alongside of a doctor say that they have no idea what is going on. This is mainly because you need to explain in detail why you are billing the insurance company to begin with. Under ICD-10, you must document as much information as you possibly can so that everyone is on the same page. The insurance companies want to know what the status is of the patient. Is there health improving or are they having to get more treatments. The important question that insurance companies are now asking is why? Why should I write your medical practice a check for $20,000? Why shouldn't it be $5,000? Does the patient really need all of the services that you are giving to them? Are you just trying to make more money off the insurance company? These are serious questions that insurance companies are asking today.

The worst decision that a doctor can make is to try and do medical billing themselves. It takes years of study to become an expert at billing. Doctors must work side by side with their coders. They must discuss anatomy with their biller so that they understand what to write down when submitting claims to the insurance companies. The more that you do this, the better turnout you will have. Medical billers today should know more about anatomy because they need to describe to the insurance company what is going on with the patient.

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