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3 Unbeatable Reasons to Outsource Medical Billing

Physicians and healthcare facilities are continuously battling decreasing reimbursement rates from insurance companies and rising operational costs. All these factors make medical billing critical for a physician or a healthcare practice.


While some practices keep the billing process in-house, an increasing number of practices are outsourcing the medical billing to a company that has expertise in medical coding and billing. Here are 3 reasons why outsourcing your medical billing can be the best practice for your healthcare facility or practice.

Faster Claim Processing

To optimize your cash flow, every claim should be paid quickly and accurately. Since in-house staff has enough on their hands, they do not have the time to examine and follow-up on every claim. However, these claims have to be submitted promptly and accurately. Healthcare providers outsource their medical billing to reduce the administrative burden on their in-house staff. Medical billing companies are not only quick but also accurate with the submission and processing claims.

High-Value Claims

When a medical practice staff is overwhelmed with billing and other administrative tasks, the quality of patient care may be affected. In addition, some healthcare practices may focus on larger high dollar value claims because they form a greater percentage of their cash flow. But these could create long-term complications.


The lower value insurance claims may become a write-off and that is not good for a practice’s bottom line. Practices need to identify and work on claims with processing issues. But back office support staff in a medical practice often don’t have enough experience to efficiently manage the billing process. Outsourcing medical billing allows your staff to focus on other important aspects of managing a practice, such as improved patient care.


Medical billing services are experts in medical billing. Years of handling medical billing and revenue management provides them with a specialized set of skills and deep knowledge of the industry. Skilled medical billing services has the required expertise, infrastructure and software to process insurance claims efficiently. This helps medical practices save a significant amount of money.


To learn more or to take advantage of the top specialty medical billing services, such as pain management billing or behavioral health billing services, call Emerald Health LLC in Massachusetts at 855-650-9906 Today.

3 Revenue Cycle Issues You Can’t Ignore in Medical Practices

Many persistent medical billing and revenue cycle issues are detrimental to a medical practice’s bottom line. Most in-house billing staff simply reacts to problems instead of proactively preventing them. However, if your billing staff’s focus is on fighting urgent issues, they may be unable to identify the source of these issues. This would prevent building an efficient revenue cycle management system.


From processing first time claims to denial management and patient collections, the entire revenue cycle should work in a streamlined manner.


Here are 3 problems that medical billing departments face constantly.

Patient Collections

It is critical that patients be educated about the details of their specific insurance plan. All patients may not know exactly what their insurance actually covers.


The growth of high-deductible plans also makes it necessary that patients should understand their financial responsibility. If this education is imparted early, patients are likely to have a better overall experience. Better informed patients will trust you more, contributing to a better doctor-patient relationship.

Denial Management

Denied claims are a huge problem for most in-house billing departments. Denial management includes efforts to reduce denial rates as well as following up on denials, resubmitting them and getting them paid.


The fastest way to reduce denials is have clear and open lines of communication within the practice. You need to organize workflow in a manner that helps to prevent denials and manage them if they occur. Billing staff needs to be trained to minimize errors so that denials can be reduced.

In-house Staff

Your revenue depends, to a large extent, on the quality of your medical billing department staff. Hiring and training top-performing medical billers and coders should be taken seriously at any medical practice. However, this is one of the biggest challenges for many practices. In addition, you need great front office and/or administrative staff who understand the importance of patient focus and flawless billing and coding. In order to be able to do this, the medical office staff needs continuous training and coaching.


It can be extremely challenging to be able to hire and train the right people, consistently update technology and infrastructure and dedicate a large part of your time and energy to medical billing and coding. Yet medical billing is one of the biggest factors that can make or break your bottom line. This is why most medical practices have now outsourced their medical billing and coding to professional medical billing companies. These companies have the required software, staff and other facilities to fulfill your requirements.

To learn more or to take advantage of one of the top specialty medical billing companies, call Emerald Health LLC in Massachusetts at 855-650-9906 Today.

Don’t Understand Medical Billing? You Might Lose Your License.

What’s the most important thing they don’t teach you at medical school? And yes there is a lot they don’t teach at medical school but arguably the most important point in your future practice is medical billing. Medical billing is incredibly confusing and the new ICD-10 has somewhere in the region of 70 000 billing codes. Remembering and understanding all of this are imperative to get the right fee for your service. This is often where medical billing services come in. The argument for medical billing services has probably been made to you a hundred times over, yes they improve revenue and cash flow and mean you get to spend more time with your patients, but you might not have thought about how the billing service industry protects you from fraud charges.

The easiest way to ensure a safe and accurate medical bill is provided to ensurers is to call in the professionals.

Yes, that’s right, medical billing services could actually save you from costly fraud charges that might leave you and your practice in tatters. But why exactly is this? Well, having a poor understanding of the procedures you are performing or incorrectly entering billing codes can have dire consequences, as Dr. Joseph Pober recently found out.


If you recall the name Dr. Pober that’s because he became famous for helping out a trump supported who was injured in a brawl. But now the New York Post is reporting he finds himself in trouble over incorrect billing. The Board for Professional Medical Conduct is set to hold a hearing about Dr. Pober that will decide whether or not Dr. Pober has his medical license revoked. Dr. Pober is currently the defendant in a fraud charge after he allegedly falsely represented a number of skin graft procedures he did. These “deviated from medically accepted standards” according to the state.


Clearly, a medical billing service would not have this kind of issue. Their service provides the correct billing codes for insurers as they are experts in medical billing who understand the process and intricacies of the American system. If a practitioner is left to their own devices with medical billing, incorrect charges can be levied on insurers. As we have seen in the tragic case of Dr. Pober, this may lead to the loss of a doctor’s license.


Therefore the easiest way to ensure a safe and accurate medical bill is provided to insurers is to call in the professionals.

Why is Accurate Medical Billing Important?

Changing regulations and stricter standards for medical billing and coding have made billing a bigger challenge than before. Medical practices seek improved billing solutions not only to get reimbursed fairly for the services rendered but also to be able to deliver the best patient care.

Need for accurate medical billing

Inaccurate medical coding and billing can cause various problems. It can result in claim denial and rejection, unhappy patients or even legal issues.


This makes it necessary to ensure that medical coding and billing processes are performed accurately and flawlessly.


HIPAA, ACA and other healthcare laws have been designed to protect patients by ensuring uniform standards and appropriate methods being followed by physicians and practices. This calls for eliminating the practice of inflating costs or inaccurate coding.

Role of Medical Coding and Billing Companies

Changes in health care-related laws and regulations have made it essential for medical practices and to follow the best medical coding and billing practices. Since this may pose a challenge since you are running a busy practice, many physicians have outsourced their billing to a professional medical coding and billing service. These companies have a large number of trained billing professionals who stay updated with prevailing standards and best practices. Outsourcing your billing ensures accurate coding and billing, timely reimbursements, increased revenue while you can focus all your attention on patient care.


To learn more or to take advantage of the top specialty medical billing services, such as behavioral health billing services, call Emerald Health LLC in Massachusetts at 855-650-9906 Today.

Prevent Common Medical Billing Errors

The payment for medical services rendered is directly affected by the accuracy of medical coding and billing. Hence, physicians and medical practices can’t afford to have erroneous or delayed billing. It can seriously impact their bottom line.


Continuous updates in the health care industry require fast-paced changes and adoption of modern technology. However, these changes also add the likelihood of errors. This is why many healthcare practices have outsourced their medical coding and billing tasks to reputed medical billing companies. These companies have the required capabilities, such as trained staff and regularly updated software and technology.


Errors in medical billing not only impact your bottom line but also the patients. Errors can make patients face financial issues or being pushed to pay for services they didn’t receive. This can cause patient dissatisfaction which doesn’t bode well for any medical practice.

Common Billing Errors


  • Treatment and diagnosis code mismatch
  • Not justifying medical necessity
  • Entering wrong data
  • Duplicate billing
  • Careless use of balance billing
  • Failure to verify insurance coverage
  • Undercoding / upcoding
  • Unbundling services

Prevent Medical Billing Errors

Errors mean claim denials and rejections. Correcting claims and resubmitting them can take a lot of time and negatively impact a practice’s cash flow. Hence, it makes sense to prevent these errors in the first place. Verifying patient information, checking that diagnosis and treatment codes match, proper insurance verification and hiring a medical billing company with the right expertise can help you avoid billing errors.


To learn more or to take advantage of the top medical billing services offered by one of the best medical billing companies in Massachusetts, call Emerald Health LLC in Massachusetts at 855-650-9906 Today.

Avoid Expensive Medical Billing Errors

The financial health of your medical practice depends upon the doctors, nurses, other staff and your image as a leading healthcare practice. Good practice management also needs to take into account whether there is any money drain due to scheduling issues, unpaid claims, or ineffective technology solutions.

Unfortunately, a large number of medical bills contain errors. You obviously want to keep them away from your practice. Billing errors can cost you a great deal. To avoid such errors in your practice, here are the most common errors you should watch out for.

Data Entry Errors

This is the most common coding and billing error. From incorrect patient information to misstating the number of nights a patient stayed at an in-patient facility, such mistakes can lead to the claim being denied by the insurance provider.

Coding Errors

Coding errors are equally frequent and can easily lead to denials. Coding errors include –

  • Diagnosis and Treatment mismatch – payers may deny a claim because the coding of diagnosis and treatment do not match.
  • Unbundling – the provider charges related services separately.
  • Upcoding or Undercoding – bills don’t accurately represent the services received by a patient.
  • Failure to verify insurance in advance

How Can A Practice Avoid These Mistakes?

  • Verify and double-check patient information
  • Always verify insurance beforehand
  • Use intuitive, easy to use software
  • Trained, skilled billing staff
  • Outsourcing billing to a professional medical billing service who have the latest technology and a large number of skilled staff to take care of your coding and billing needs. They can keep track of claims and denials in real-time. By reducing common errors, a medical billing service can help you preserve your bottom line.

To learn more or to take advantage of specialized billing services, such as behavioral health billing services offered by the best physician and medical billing services, call Emerald Health LLC in Massachusetts at 855-650-9906 Today.

How to Check Patient Engagement

A medical practice that doesn’t understand the degree of patient engagement and satisfaction will not be able to reproduce the positive experience and improve their practice.

Here are 4 great ideas to make it easier for you to measure your practice’s patient engagement.

Happy Staff = Satisfied Patients

Happy employees lead to happy patients. Improved patient engagement naturally depends on how trained and content your staff is.

This means surveying your staff (as well as patients) will give you an idea of whether the patients like or dislike your practice.

Create an Engagement-Friendly Environment

To ensure a high degree of patient engagement, you need the office to be designed as a place where engagement feels natural, for example, a waiting room and front office that is warm and puts patients at ease.

Your staff should remember that patients are not feeling a hundred percent when they walk-in. They may be tired, scared or anxious. A genuine smile and assurance can reduce the patients’ mental discomfort.

Talk to Patients

Survey your patients with questions related to engagement, such as how professional the staff is, whether the patients felt they were being listened to and so on.

Be Present

Your staff may not be physically available round-the-clock but software and smartphone apps can make this possible.

A large percentage of patients are comfortable communicating via mobile apps, that it is worth exploring the idea of a patient portal with the EHR software.

To learn more or to take advantage of the latest software and medical billing services offered by the one of best top medical billing companies, call Emerald Health LLC at 855-650-9906 Today.

Medical Billing – Isn’t It Time to Avoid These Costly Errors?

As much as your medical center will strive to offer the best patient care, you still must consider it as a business. There are so many elements that can be costly in terms of time and financials and so, it is important that if you are going to avoid making errors within your practice, you have the best staff, the best technology, and processes too. If we look at medical billing and coding, we know that it is, of course, one of the most crucial elements of the medical industry and yet, for so many medical practices, there can be an extraordinary number of costly errors.


Many of your health expenses are paid as a result of health insurance and this is why those who are involved in the medical billing processes must be at the top of their game. Too much is at stake for errors to be made. Mistakes can build up too.


Accuracy is all-important.


Legislation changes constantly but do you have time to keep your finger on the pulse of medical billing? As a healthcare provider, it’s your responsibility to ensure that you and your employees are well-informed and that you meet and uphold the changes in medical standards. Of course, this is not always as easy as it sounds, in fact, at times, it can create longer hours and much more work.


After a busy day treating and reassuring your patients, the last thing you may want to deal with is changes to billing legislation. Therefore, it makes sense to have a professional company that you can delegate all billing errors to and who will keep up with important changes. As these people are trained to a high level and, their training is ongoing so to avoid costly mistakes, they have all the capabilities to take this chore off your hands. Plus, they are far more accurate than most people could be. This saves you time and money.


What happens when billing is inaccurate?


Even with the best of intentions, it is so easy for errors to be made. Unfortunately, the simplest of errors can turn into the most complex of problems to resolve. Ultimately, it leads to your patients potentially being put under financial hardship. It is no surprise when they feel frustrated and unhappy as a result. Of course, mistakes can be made but, if your patient is already under duress and worried about their health, this is just one more problem to deal with it at a time when physically or emotionally, they may not be capable of dealing with it.


There are many common errors all of which take time to resolve.


  • Wrong data entered
  • Duplicate billing request
  • Insurance coverage unverified
  • Upcoding
  • Undercoding etc.




Why add extra administrative issues to an already busy day? Doesn’t it make absolute sense for this highly-important role to be given to companies who do it so well and who will take the pressure away from you and your team? Ultimately, fewer errors will equate to less stress and enable you to focus on patient care and so, outsourcing medical billing is undoubtedly the way forward.

How Your ASC Can Improve Pain Management Billing?

Ambulatory Surgery Centers (ASCs) or outpatient surgery centers provide same-day surgical care. This may include diagnostic and preventive procedures. However, ASCs may face problems related to physician reimbursement and accurate pain management billing. Staying viable can pose a challenge to ambulatory surgery centers.

If you run an ASC and want to stay competitive and profitable, you need to overcome in-house billing challenges while staying compliant in the changing healthcare landscape.

Here is a quick look at a few strategies that ensure successful reimbursement.

Efficient medical coding

Experienced coders can make a huge difference to your pain management coding. For example, in spinal procedures, they must be able to match the spinal nerves involved in a surgery to the proper code. Advancements in surgery means addition of new instruments and medical products. The coding staff needs to be aware of appropriate coding practices for each new medical device to ensure claim approval. This is easily done at a professional coding and billing service provider since their staff is adequately trained and experienced and stay updated on the latest changes in healthcare.

Physician documentation

Wrong or incomplete documentation and lack of relevant details can cause coding errors and lead to claim denials. So, doctors must include the aim of the procedure and how it is performed.

Stay current with changes

Billing policies vary with carriers. The methodology of pain management reimbursement has drastically changed. The same documentation procedures that may have once been effective can now result in denials. Your medical coding staff should be aware of these changes and updates to each policy’s requirements. Professional medical coding and billing companies can do this easily.

To learn more or to take advantage of the services offered by a professional pain management billing and coding company and behavioral health billing services, call Emerald Health LLC at 855-650-9906 Today.

Medical Billing Specialists – Optimize A List of Questions Before Hiring

 Optimize A List of Questions Before Hiring

As a medical professional with a busy medical practice, you will want to ensure that all your administrative processes work smoothly so that you can focus on the areas of the business most important to you – that of patient care. In the same way that you would interview potential new members of staff, it’s wise to compile a list of targeted questions so to ask any medical billing specialists before hiring. This way, you are more assured of a good fit and as it is an important decision, it will give you peace of mind by doing so.  In many ways, medical billing specialists become an important part of your team even if are not actively employed onsite.

Hiring the right company can make a big difference to your financials as it can ensure that your cash flow is interrupted. This is an important element for all business but it also ensures a healthy bottom line. Each part of a medical centers processes are important but if billing errors are made, this is a costly drain on time and only causes delays before payments are made.

Therefore, you may have many questions but, as a starting point, consider the following:

What qualifications do you have?

Before you sign on the dotted line, it’s a good idea to ask to see company references. If you know someone else who uses the company, this may naturally give you peace of mind, but otherwise, review the website for feedback or, ask for references. Most businesses will not mind.  You also need to consider whether they have an in-depth knowledge of medical codes and that their qualifications are up to date. As legislation changes frequently, it’s important to know that they are proficient. If you specialize in a specific field of expertise, you may wish to check whether they can provide you with the service you need.

What does the service cost?

Understandably this is an important consideration and you need to know whether they charge for a percentage of the charges which have been collected or if it will be a flat rate. You also need to check whether there are any additional fees to be taken into consideration. This may include data conversion, initiation or termination. Find out what is included in the service. If you opt for a cheaper service, you may find that the service is by no means comprehensive. So, less is not always more.

Find out more about how your account will be managed

Check for any frequency of reports and also, what data will be included. You may wish some reports to be customized. Consider their HIPAA compliance plan and whether your patient data is safe. In addition, who will be managing the account? Having a contact name and number should any problems arise is extremely important. It may be a big consideration for you to outsource this aspect of your business to any medical billing specialists so it is understandable that you want to be satisfied that the service will exceed expectations. Also, who do you contact if this person is not available or out of the office?

It’s also worth checking out the company’s website to ascertain the full complement of services available and this will help you to gain the right service for you.