FAQs
Your questions answered
General
What are the benefits of outsourcing my medical billing?
With a dedicated team of medical billers handling your claims, the benefits of outsourcing include reduced billing errors, timely follow-up on denied claims, and quicker turnaround time for payments being processed. By outsourcing, your practice also no longer bears the weight of overhead costs that in-house staffing requires. These costs include staffing, office space, and supplies. Due to the high demand of billing responsibility, staff usually wear multiple hats and are unable to sufficiently bill out clean claims, post payments, and follow-up on outstanding claims in a timely manner. These challenges result in lost revenue.
What are the common challenges with medical billing?
Some common challenges practices face includes insurance and referral verification, coding errors, claim denial follow-up, delays in payments being issued, staying up to date with credentialing, staff training, patient communication, and technology issues.
What are the benefits of electronic medical billing vs. paper-based billing?
Nowadays, most insurances require electronic submissions as the only acceptable form of claim submission. This is because electronic submissions are superior since the claim is sent to the insurance carrier instantly, while also reducing postage costs. In contrast, paper submissions are beholden to mail lags and postage. The use of electronic submission will also result in faster payment turnaround time.
What is the difference between In-Network and Out-of-Network billing and how it impacts patients?
In-Network billing involves healthcare providers who have agreements with a specific insurance plan. This results in lower costs for the patients. Out-of-Network billing refers to when a patient is treated by a provider who is not in their insurance network. Typically, this results in higher costs and greater out-of-pocket expenses for the patient. Understanding the differences plays an important part for the patient and their healthcare decisions.
Patients will call and complain about bills they received for services that they were provided months or years ago. Why is that?
It's truly dependent on how long it takes the patient’s insurance company to respond. There could be other issues holding it up too, such as whether there is additional insurance the balances need to be processed through or if your medical billing team determines the insurance needs to be reprocessed. All of which is what determines how long the process will take.
Company
In which billing specialties do you offer expertise?
At HealthRev Works, we have a broad level of knowledge as it pertains to provider specialties. Over the years, we have widened our expertise. When we onboard a new client, we ensure payer policies and billing guidelines are followed for the specific specialty of the practice.
Does HealthRev Works offer references?
At HealthRev Works, we value our clients and their honest testimonials regarding our services. Client satisfaction is very important to us. We would be happy to provide references.
How much billing experience does your billing staff have?
Over the course of 30 years in business as a top billing company, we have highly skilled billing professionals that manage large volume operations on a daily basis for multiple specialties.
How will you charge me for your medical billing services?
The pricing depends on which billing package you choose. For our Core package, a flat monthly rate is changed per provider. For the RCM and RCM+ packages, a professional service percentage fee is applied to the gross payments posted. Invoices are billed monthly for activities recorded during the last fiscal period.
RCM
How much billing experience does your billing staff have?
Over the course of 30 years in business as a top billing company, we have highly skilled billing professionals that manage large volume operations on a daily basis for multiple specialties.
Do you review claims before they are submitted?
Yes. Claims are reviewed by our highly skilled billing team to ensure information is submitted accurately and as clean as possible. Additionally, our built-in claim scrubber software reviews claims before they are sent out to the insurance for processing.
Are there any strategies that help minimize claim rejections and/or denials?
Minimizing claim rejections and denials are crucial to optimize your revenue. Every time a claim is denied it is at risk of not being reimbursed. Some of the ways your practice can help mitigate that risk is to make sure insurance information is verified, any referrals or prior authorizations are obtained prior to the patient being see, all documentation is up to date and accurately supports the level of service you are attempting to collect on, ensuring that claims are going out as soon as possible to avoid any timely filing issue and also keeping staff up to date on the latest coding updates and payer policies.
Services
What type of reporting do you offer?
As part of our service, we provide monthly performance reports. The robust offerings will ensure providers receive detailed financial information for the fiscal period, as well as year-to-date data. We also provide ad-hoc reports and work closely with accountants for special requests.
Will there be a dedicated team handling my account? What should I do if I need to contact you outside regular business hours?
Yes. You will have a team of billing professionals that will be available for your entire practice throughout regular business hours. Our managers will be available outside of normal business hours for urgent matters. We pride ourselves on getting back to our clients in a timely manner to help with any questions or requests they may have.
Do you provide credentialing services?
Yes, we have an internal credentialing management team that will handle all of our clients credentialing needs.
Do you provide patient billing services?
Yes. As part of our services, patient billing is included. In addition to sending out statements, HealthRev Works has a dedicated call center to assist patients with their billing questions. Patients also have the ability to make payments over the phone while speaking with a call center representative or through a dedicated online credit card portal.
Software
Do I have to change software platforms to bill my charges?
No. Our team is able to handle your billing out of multiple systems.
Do you recommend a billing software to use?
While we are able to operate in multiple systems, our preferred billing software is Harris CareTracker. We utilize various methods of receiving your billing so that you can continue to use your EMR without interruption to your billing.
How do we send information to you if we are not using your PM system?
We have different means that would allow you to send your claim information over to us with little to no effort taken on by your practice. We support electronic interfaces that connect from your EMR system to our billing system without any manual effort required. We have a cloud-based document management system where you can upload encounter sheets effortlessly, which our billing team will process through our billing system.