The Importance of Medical Billing Training and Certification

  • May 15, 2017

  • Medical billing professionals are a necessity and play a critical role in healthcare. Their work is extremely detail-oriented, complex, and directly affects the financial success of healthcare practices. The demand on healthcare providers has been increasing and will continue to do so. Ambiguity among payers can make claims processing a frustrating process, and that is why many practices are enlisting the help of highly-trained, certified medical billing professionals to ensure efficiency of their revenue cycle management.


    Advantages Of Hiring A Trained And Certified Medical Biller

    Communication Between The Provider, Patient, and Insurance Company

    Professional medical billing services ensure that healthcare providers get paid for the health care delivered to their patients. They are the intermediary between the patient, the provider, and the insurance company. By focused communication with all three parties, a medical billing professional manages and arranges payments from payers to the healthcare provider in a timely manner.


    Reduce the Number of Accounts Receivable Days

    It is a very time-consuming process following up with insurance companies and patients in regards to overdue payments. Medical billing professionals, communicate and follow up with patients and insurance companies appropriately and aggressively, if necessary, in order to collect payments for your medical practice. A designated person dedicated to following up on overdue payments will significantly decrease the number of days that an insurance claim is outstanding and greatly increases revenue for the medical provider’s practice.


    Compliance with HIPAA and OIG Regulations

    A superbill (an itemized form that outlines all services rendered to the patient) is used by medical billers in order to file a claim with the patient’s insurance company. When creating a claim, medical billers manage the patient’s personal information, their medical history, the specifics of their insurance coverage, and the details of their care, such as what treatments were used and why.

    This information is used by medical billers in order to create accurate claims to submit to the health insurance companies for reimbursement. It is of the utmost importance that the medical biller is thorough. If the claim does not follow regulations according to the Health Insurance Portability and Accountability Act (HIPAA) and the Office of the Inspector General (OIG), the claim will not be considered complete / compliant, and payment will be denied.


    Do You Really Need a Trained and Certified Medical Biller?

    The advantages of hiring trained medical billing professionals are directly related to the success of your practice’s revenue cycle management. At RevPro Healthcare Solutions, all of our medical billing professionals have extensive experience in getting claims paid. To learn more about how we can help you maximize revenue for your practice, contact us below or call us at 561-578-8400.