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Health Insurers Need To Work With Physicians To Reduce Administrative Cost.
Delays in physician payments from health insurers add to cost of healthcare and create a distraction from patient care. Several causes for delayed payments could and should be addressed by developing standard claim submission processes, improved claim automation and integration, and improving responsiveness to medical billing service questions and follow up.
With the recent focus on automating healthcare practices with stimulus dollars these are some obvious areas that could have an impact on overall healthcare cost savings and medical billing services cost.
A wide variation in policies and procedures for submission of claims and payments between health insurers creates confusion for physician offices and billing services adding to the cost of doing business. Standard policies and procedures would streamline claims submission.
Improved technology integration between the physician office and claims processing that truly automates work flows and prevents duplication of work between the physician office medical billing service and the health insurer’s claims adjudication process should be included in healthcare stimulus programs.
Additional healthcare savings could be provided with Health insurers staffing levels required to provide adequate staff to promptly provide claim assistance, follow up and feedback to physician offices. Healthcare facilities have a requirement to maintain adequate staffing to provide service to patients.
Provider manuals with up to date policies and procedures should be available from the health insurer. Provider manuals available online at the insurers’ website could be extremely helpful and a cost effective way of assuring information is always up to date for the physicians’ office.
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About the Author:
PGM Medical Billing Services
At PGM, we believe physicians should focus on practicing medicine, not submitting claims and collecting payments. As insurance carriers and HIPAA requirements change, physicians are dedicating more and more of their time and resources to administrative tasks and red tape. By effectively managing this time-consuming work, PGM gives time back to physicians allowing them to do what they do best.
Our specialized medical billing service is focused on maximizing medical provider reimbursement. For the past 30 years, PGM’s medical billing service has been helping physicians not only get paid more, but get paid faster. Our complete practice management solution includes claim submission and follow-up, payment posting, advanced claim scrubbing to minimize denials, and much more.
PGM medical billing services will maximize your collections, reduce your time to payment and help you lower and better manage your expenses, all dramatically improving your bottom line.
By using PGM, you will liberate your staff of tedious billing and remittance tasks to focus on patient care and growing your practice. We offer our clients a full range of practice management and medical billing solutions. From extending our proprietary software to your practice via the internet, to our full service practice management service, PGM will work with you and your team to tailor a solution that best suits the needs of your individual practice.
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