If you are a midwife running a private practice, you know that billing and insurance claims can be a major hassle. Not only is it time-consuming, but it can also be very confusing. It can even distract you from patient care. This is why many medical practices are outsourcing their medical billing. Outsourcing can save you time and money, and it can also help improve your bottom line. In this blog post, we will discuss 15 reasons why you should outsource your medical billing.
1. Time SavingsOne of the biggest reasons to outsource your medical billing is time. When you outsource your medical billing, you can free up time that you would normally spend on billing and insurance claims. This extra time can be used to see more patients, work on other aspects of your practice, or take a much-needed break!
2. Money SavingsAnother great reason to outsource your medical billing is for the money savings. When you outsource your medical billing, you can save money on office staff costs, office space, and supplies. You can also save money on medical billing software and hardware because the medical billing company will take care of that.
Outsourcing medical billing services can also help you save money on collections. When you outsource your medical billing, you can have a team of experts from the medical billing company working on collecting so that you can focus on seeing patients.
3. Improved Bottom LineOutsourcing medical billing services can improve your financial performance. This is because a medical billing service can help you save money on in house employees and overhead expenses. In addition to these reduced costs, outsourcing medical billing can help you get paid faster! How? When you hire medical billing services, you can take advantage of the latest technology and software and their revenue cycle management expertise. This means that your claims will be processed faster, you will get paid sooner, and your cash flow will be stable.
4. Reduced StressOne of the best reasons to hire medical billing services is for the reduced stress. When you outsource your medical billing, you can rest assured that your billing and insurance claims are being handled by a team of professionals from a medical billing company. This can take a lot of the stress off of you and allow you to focus on seeing clients.
5. Increased AccuracyUsing an in house billing team can result in more billing errors because your staff may not be as experienced or may not have the time to focus on billing. When you outsource your medical billing, you can increase the accuracy of your billing and insurance claims. This is because you will have a team of experts from the medical billing company working on your claims. They will make sure that all of the information is correct and that your claims are filed correctly. This can help you avoid billing errors and save you a lot of time and money in the long run.
6. TimelinessAnother great reason to outsource your medical billing is for the timeliness. Medical billing services use the latest technology and software, so choosing to outsource billing means that your claims will be processed faster and you will get paid in a timely manner.
7. Easier Access to Billing and Insurance InformationWhen you outsource your medical billing, you will have easier access to billing and insurance information. This is because the team of medical billing services experts will be handling all of the claims and paperwork for you. This can save you a lot of time when you need to access this information.
8. Reduced Chance of Fraudulent ActivityOutsourced billing services can reduce the chance of fraudulent activity. This is because the outsourced billing team is made up of experts who know the ins and outs of the medical billing process. This outsourced billing team will be handling all of the claims and paperwork for you. They will be able to spot any red flags or suspicious activity.
9. Stay Up-to-Date EffortlesslyOne of the many things that can affect reimbursement is changes in coding. By outsourcing medical billing services, you can be sure that the team of experts from the medical billing company will stay updated on the latest coding changes. This way, you can be assured that your claims will be processed correctly.
10. Continued Support and TrainingOutsourcing medical billing will also allow you to receive support and training. This is because the team of experts will be available to answer any questions that you have on the medical billing process. They will also provide ongoing training so that you can stay updated on the latest changes in the industry.
11. Higher Staff MoraleYour own team can be bogged down by the mundane tasks of billing and insurance claims. This can lead to low morale among your in house staff. When you outsource your medical billing, you can free up your in house team to focus on more important tasks. This can lead to higher morale among your staff and a more positive work environment.
12. More Time to Focus on PatientsWhen you outsource your medical billing, you can focus on providing the best possible care for your patients. This is because outsourced medical billing services will allow you to have more time to spend on patient care and less time spent on billing. This is why medical billing services play such an important role in any midwifery practice
13. Higher Patient SatisfactionPatient satisfaction is important for any healthcare organization. When you outsource your medical billing, you can focus on providing the best possible care for your patients. This can lead to improved patient satisfaction and a better reputation for your organization.
14. Better Use of Your TimeAs a busy midwife, you likely do not have the time to focus on billing and insurance claims. When you outsource your medical billing, you can use your time more efficiently by focusing on other aspects of your practice. Not having to worry about your billing needs can give you more time to focus on your practice’s growth strategy, such as how to gain more revenue, improve your services, and your organization’s success. This can improve your decision making process so you can focus on your key performance indicators and set up your medical practice for success.
15. Increased Income Due to Proper Follow-Ups40% of many midwives' income is due to proper follow-up with the insurance companies. Getting the correct payments is crucial when it comes to billing and your income. Just by simply following proper follow-up procedures you can insure that you will receive the right amount that are due.
ConclusionHealthcare is an ever changing industry with increasing demands. Medical billing companies can help you achieve success as you look out for your patients’ interests. There are many reasons why you should outsource your medical billing. Outsourced medical billing can save you time and money so you can focus on treating patients. In this blog post, we discussed reasons why you should outsource your medical billing.
It is important to find the right medical billing company that will understand your organization’s specific needs so they can provide a customized solution. Our team of billing experts has the experience and know-how to help you outsource your medical billing so you can focus on what’s important — patient care. If you are considering hiring medical billing services, we encourage you to contact us today! We would be happy to discuss how we can help you save time, save money AND make you more money.
How Did Midwives Advantage Get Started?
Stacy Carruth, CPM delivered her first child in a hospital in 1983 and had the rest of her children at home with midwives. She started her midwifery education in 1992. Stacy has been the administrator of two state-licensed birth centers and attended well over a thousand deliveries over the last 30 years.
Stacy used several highly recommended third-party billers to file insurance claims, and the results were the same: "Homebirth or birth centers are not a covered service. Midwives are not recognized as healthcare providers." The list of reasons to deny claims goes on. It wasn't fair that insurance would pay for a hospital birth but refused to pay for birth centers or home births. Stacy had personal experience with the injustice of insurance and homebirth. Her husband was a federal employee, and they had excellent insurance. If she had delivered in a hospital, her co-pay was $200. Since she delivered at home, Stacy paid thousands to her midwives, and the insurance paid nothing. Someone had to conquer this injustice; as a mother and a midwife, Stacy was the perfect person for this mission.
In 2009, Stacy was introduced to an attorney that won a $180M settlement from United Healthcare and a $120M settlement from Aetna for underpaying out-of-network claims. After that, physicians wanted him to terminate their in-network contracts because of the low-paying fee schedules. He formed Edge Medical Solutions, Inc. to submit out-of-network insurance claims for orthopedic surgeons, obstetricians, physical therapists, surgical first assistants, and family practice doctors. Shortly after they met, he told her about an upcoming meeting to negotiate out-of-network agreements for Edge Medical Solutions with several hundred insurance companies.
Stacy knew this was something she needed to be a part of and was the first midwife to join Edge Medical Solutions. Stacy had tried everything else to get claims paid; this was worth a try. The attorney didn't have high expectations for the claims, even with his Edge Medical agreements. She filed several claims for deliveries, and to their surprise, big checks started rolling in. After seeing the money Stacy was making, the attorney asked her how many midwives attended home and birth center deliveries. He was surprised when Stacy told him there are thousands of midwives, and out-of-hospital births are very popular. The attorney had a brilliant idea for a new company, and National Birth Centers, Inc. was born.
They incorporated his knowledge from years of experience as an attorney and Stacy's knowledge from years of experience as a midwife. They formed a nationwide business that focused solely on getting birth centers and home birth midwives paid by insurance companies. Through their system, midwives become contracted providers of National Birth Centers. They submitted claims to the insurance company with the midwife as the attending provider, and these claims were paid under the company's established agreements.
They built National Birth Centers, Inc from 2009 until 2011. In the Fall of 2011, the attorney called Stacy into his office and told her he wasn't making the money he had anticipated with the midwifery billing venture, and he was closing the business. They had come so far in billing for midwives, and Stacy knew more midwives needed this service. She couldn't let the momentum die. With his blessing, Stacy continued the business, and she has continued to a unique realm of billing for midwives.
Today, Stacy Carruth, CPM is proud to say that midwives in 38 states have realized the benefits of getting paid the Midwives Advantage way!
Empowering Midwifery Education has an amazing online course for midwives around all the billable services to process with insurance companies. The midwifery billing and coding course is packed with over twelve hours of videos, resources, and tools to help any midwife with setting up billing insurance plan with their private practices. We start with basics of billing and coding like ICD 10 codes, CPT codes, and POS codes typically billed by midwives to insurance companies. There are hours of content about billing in or out of network coverage to plan, how to negotiate with insurance companies, creating financial policies, and outstanding patient balances. So much is covered in this affordable, valuable resource to any midwifery practice. Be one step ahead of the insurance billing curve and take this course to advance your practice to the next level of success!
There are over 15hrs of content available! Enjoy the lifetime access to dive deep into specific professional services that midwives can bill for part of their scope of practice (maternity care, newborn care, gynecological services, well women care, contraception, primary care, & telemedicine). This is by far the most comprehensive billing and coding training for midwives out there!
Comprehensive Billing and Coding for Midwives | Empowering Midwifery (teachable.com)
When you interview for a medical billing position, you may be asked several questions about your professional experience, industry knowledge, work practices and problem-solving skills.
Knowing what questions to expect can help you prepare answers ahead of time and practice before you meet the hiring manager. In this article, we explore some of the most common questions asked in a medical billing interview to help you get started.
Most common medical billing interview questions: When interviewing for medical billing roles, there will be some common ground from job to job, company to company. Here are 10 questions with example answers so you can craft your own effective responses:
In what medical billing specialties are you experienced? Medical billing specialties are based on the type of care patients receive from the provider. This question allows you to showcase how your experience meets the needs of the facility. In your answer, outline what patient procedures you've billed for and any that you would like to gain more experience in if applicable. Some specialties include billing for internal medicine, family medicine, anesthesiology, dermatology and neurology.
Example: "In my previous role, I did medical billing for an oncology practice, which I had to research and teach myself since it was my first time billing those specialized procedures. Additionally, I also have experience billing for hospitals, family and internal medicine as well as pediatrics."
What types of medical records software have you used? Medical billers typically review digital patient files, submit claims through online portals and do most of their work using industry software. When answering this question, list the software you've used in previous roles, how you used it and any training or certifications you've received. If the job description lists a specific software for the role, be sure to address your knowledge of that software, too.
"Over the past six years as a medical biller, I've worked with eClinicalWorks as well as CareCloud and Charts EHR. With eClinicalWorks, I monitored claims processing and scrubbing to ensure claims were filed with insurance companies and patients received accurate bills.
I also used it to verify patients' insurance information and eligibility. In my last role, I used CareCloud and Charts EHR for revenue cycle management, filing both paper and digital claims and sending bills to patients. With each software, I reviewed the available analytics to track how much we billed, how much had been paid by insurance at any given time and the amounts of outstanding insurance claims."
Explain a time when you had to resolve an error with a claim in the clearinghouse. A clearinghouse is an online portal where medical billers submit claims to insurance payers, and part of this process involves payers scrubbing claims and sending back any with inaccuracies. Use this question to demonstrate your knowledge of the clearinghouse and show how you address these rejections.
Example: "When there's an error with a claim, that means that the payer has found something wrong with the information we provided. My job as a biller is to review the electronic remittance advice, or ERA, that breaks down each element of the claim and the items that they're denying.
I then compare the information in our electronic health records system, or EHR, making sure the patient's name and date of birth are correct, the right amounts are attributed to copay, coinsurance and deductible amounts. I often review physician notes, diagnosis codes and procedure codes to make sure everything is correct.
Whenever I find the errors that initially caused the payer to reject the claim, I make sure to correct the information in the EHR system before resubmitting to the clearinghouse. This ensures our in-house records match the payer records." Can you explain the difference between copays, deductibles and coinsurance? These three terms represent the amount of money a payer and a patient pay for care over an insurance contract. This question assesses your knowledge of these important differences since medical billers are responsible for ensuring each amount is correctly charged on a claim. In your answer, give the definitions of each term and explain how you use this information on the job.
Example: "A copay is what the insurance requires a patient to pay when they visit. This amount may vary depending on whether the patient sees a general practitioner or a specialist. Coinsurance is any amount of a claim that an insurance payer doesn't pay. Some patients may have supplemental insurance to cover these amounts. Finally, a deductible is the amount that the patient pays out of pocket, in total, for care expenses before the insurance company pays.
Knowing the difference between these three terms help me double-check that money is charged toward the right insurance element on the explanation of benefits, or EOB, ensuring patients only pay the amount they have to pay based on their insurance plan."
How do you follow HIPAA regulations when managing patient accounts? Every patient must sign a Health Insurance Portability and Accountability Act (HIPAA) form when they see a provider. This form outlines a patient's rights to keep their medical records and insurance information private or accessible to other people as necessary. Use this question to highlight your understanding of these regulations and the importance of protecting patients' health information.
Example: "When a patient calls regarding their account, I always verify their name, date of birth and account number, if they have it. If a family member or caregiver is calling on behalf of the patient, I ask for the patient's information along with the caller's name and relationship to the patient. This allows me to check that this person is listed on the patient's HIPAA form, and I can speak with the caller about the patient's account."
If a patient calls the billing department upset about their account, how do you handle their concerns? Many medical billers are responsible for taking patient calls regarding billing and insurance, and patients can often be confused or upset when they receive a bill from their provider. This situational question tests your customer service and problem-solving skills, and you can answer this question using a hypothetical scenario or a real-life example from your experience. Use the STAR method for your answer to:
Example: "In my last role, I had a patient call about her daughter's recent visit to the doctor for strep throat. She was concerned about the amount we had billed her after filing a claim with her insurance, so I talked her through the bill over the phone. I first assured her that I could help her understand the amount she was charged. Then, I explained each procedure we billed her for—the visit and the test. I also went over her EOB to show her how much we charged for the copay when she came in, how much the insurance company was going to pay and how much the coinsurance was, which was her responsibility to pay.
The woman said that she had been confused by the different amounts and was grateful for me helping her through it. I then took her payment over the phone so that we could settle her outstanding charges as soon as possible." Explain how your previous medical experience can help you in this role. Some people become medical billers after being in direct patient care roles, and this experience can be helpful in many ways. If you have this previous experience, use this question to highlight those skills and the ways you plan to apply them in a medical biller role. Consider listing an example of a situation in which your knowledge can be an advantage.
Example: "As a former medical assistant, I'm familiar with the process of documenting diagnoses, tests and procedures, and I have a lot of experience working directly with patients.
My knowledge of note taking can help me better understand the physician notes on patient records, allowing me to more accurately create claims. Also, my bedside manner translates to customer service, so I am comfortable talking to patients who may be confused or upset about their bills."
How familiar are you with medical terminology?Patient charts and records often include doctor's notes on what kind of tests and care a patient received. Medical billers and coders often need to interpret these notes to accurately code these claims. In doing so, they must be familiar with some medical terminology, like certain conditions, procedures, tools and other jargon or abbreviations. In your answer, include an example of an instance where your knowledge of medical terms helped you on the job.
Example: "When I was going to school for medical billing, I took a course on medical terminology so I could learn how to interpret notes on patient records, speak with the medical staff about patient accounts and help patients better understand their accounts.
One time, a claim came back with an ERA that stated the diagnosis and procedure codes didn't coordinate. Since a diagnosis code has one or a few procedure codes that relate to it, I had to go back to the notes to double-check what the doctor diagnosed the patient with and what steps they took to care for them. I found that the coder may have made a clerical error while inputting the code, so I fixed the claim with the correlating code and resubmitted the claim."
Do you have any medical billing or coding certifications?There are many forms of billing and coding certifications for this field, including Certified Professional Coder (CPC), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Inpatient Coder (CIC) and Current Procedural Terminology (CPT). In your answer, identify whether you have any relevant certifications. If you don't have a certification, consider expressing interest in becoming certified to show your willingness to learn.
Describe how do you prioritize different tasks throughout the dayA medical biller has many responsibilities and being able to manage your time and tasks each day can ensure your provider or healthcare group is paid on time and in full. Use this question to outline your day as a medical biller.
Example: "Each morning, I start by returning voicemails and emails from patients. Then, I check any ERAs, denials or rejections from the clearinghouse. I work with my team to research the errors and fix claims in the EHR system.
Then, I spend time going through the previous day's patients, making sure the physician's notes are signed and the claims are scrubbed. I then submit those claims through the clearinghouse. Throughout the entire day, I answer phone calls and answer questions from patients and providers about claims and accounts."
Additional medical billing questions and answersWorking in medical billing can vary greatly from place to place while having a lot of detailed specifics in each, which makes for especially broad possibilities in interview questioning. Here are some additional questions you can practice: