Archive | August, 2011

Medical Billing Collections Specialist

16 Aug

Medical Billing Collections

The services involved in medical billing collections are as diverse as the scope of the career itself. Although it is sometimes equated with medical coding, medical billing collections is actually a wholly different aspect of the healthcare information field. For one, medical coders concern themselves with choosing the correct diagnostic and procedure codes. On the other hand, medical billing collections professionals are the ones who make decisions which help healthcare providers achieve optimal reimbursements for the services they render to their consumers.

The Job Duties

Medical billing collections are often described as the key to getting compensation for medical services rendered. Medical billers are even described as the persons to go to if you want to get paid. With the emergence of HMOs, PPOs, and insurance plans today, many doctors, medical offices, clinics, and health centers are seeking the services of medical billing collections professionals to help them streamline their respective practices and process insurance claims. That is why medical billing collections are fast becoming the top occupations in the healthcare industry.

Professional Skills

Medical billing collections deal mostly with insurance so in order for you to have a successful career in this field, you need to be trained in understanding the medical industry, health insurances, and all the complexities that go hand in hand with it.

Medical billing collections also call for working knowledge on basic and major medical coverage plans, such as the Fee-for-Service Plans, Health Maintenance Organizations (HMOs), Point-of-Service Plans (POs), and Preferred Provider Organizations (PPOs). There may also be other methods of billing patients and insurance companies so it is advisable that you familiarize with these as early as now.

Mainly Back Office

The typical medical practice is divided into two sections. The first section is the back office. This is the area of the doctors and billing specialist. It is that aspect of the medical office where personnel directly deals with patients. The other section is the front office. This is where the medical assistant will apply copayments, deductible amounts and any past on the outstanding collections to the billing specialist. The billing specialist duties involves everything that pertains to running and managing a practice – from billing and accounting, patient scheduling, electronic record storing, data organization, and so on.

The successful medical billing collections professional must know how to use a word processor or a computer. He or she must also be familiar with medical billing software and practice management systems which are both indispensable tools to speed up the processes involved in medical billing.

HIPPA Compliant Software

16 Aug

Alliance Practice Management Medical Billing software systems are fully HIPAA Compliant. 

HIPAA stands for Health Insurance Portability and Accountability Act. It is a group of regulations and standards which require major changes to how healthcare organizations handle information management. HIPAA covers such aspects of medical billing as coding, security, patient record management, reimbursement and care management as well as stringent codes for uniform transfer of electronic data, including routine changes and billing.

Learning the twists and turns of HIPAA may take time and time is something that most medical billing specialist can ill-afford. For this reason, software developers have come up with a type of software program that incorporates HIPAA compliance into the system. The result is the new HIPAA compliant medical billing software.

Alliance Practice Management’s Choice for any physician’s office is Kareo.

HIPAA compliant medical billing software builds the codes and standards of HIPAA into the structure of the system. Using this type of software product saves you from the hassle of studying the HIPAA guidelines and evaluating if your software systems meet them. Now, you no longer need to spend all this time learning the works because your HIPAA compliant software will do all the work for you in adhering to HIPAA EDI compliance rules.

HIPAA compliant medical billing software adhere to three sets of standards. These are:

  • Transaction and code sets Privacy Security

In order to meet regulation compliance, HIPAA compliant medical billing software must also cover the following entities:

Health plans, Health Care Clearinghouses and updated Health Care Provider Systems

The Benefits of HIPAA compliant Medical Billing Software

The main purpose of HIPAA compliant medical billing software is to assist medical billers meet the federally mandated HIPAA requirements. However, HIPAA compliant medical billing software may also have several other benefits aside from mere compliance. For instance, HIPAA assessment tools allow the billing agency to manage HIPAA assessments for each of its clients. They help medical practices and billing services increase productivity, reduce account receivables, and increase cash flow.

Another benefit of HIPAA compliant medical billing software is that it can simplify complicated administrative and financial data transactions. It does this by defining new codes and unique identifiers and by standardizing transactions and EDI formats.

Hospitals, physician office, home health agencies, nursing homes, affiliated providers, payers, employers, data services, and regulatory agencies are all impacted by HIPAA. That is why having an HIPAA compliant medical billing software program helps greatly in improving efficiency in practice management.