Managing ‘reimbursement claim’ challenges

The process of medical claim submissions is strewed with numerous challenges. Some of the issues pertaining to the claim are quite difficult to resolve and become very time consuming and occasionally not worth the time and effort, In which case they are just dropped. This, of course, is not the way things ought to be. To tackle the tough challenges most healthcare organizations bring in a professional billing team who can handle their financial matters while they concentrate on providing healthcare services.

What does a billing company do?
A healthcare billing company is the solution to the complete billing cycle and revenue management for a healthcare organization. We encompass our sound financial and technical knowledge to streamline and the seemingly challenging task of claiming medical reimbursements from insurance companies. We ensure accurate claims with documentation to support the claims and clear any doubts or queries that the insurance agency may have.

Introducing quicker claim submission
All medical services and provisions used for medical treatment have to be paid for. Most of these charges are covered by the healthcare insurance policy of the patient. It is our job to go through the healthcare policy and process a reimbursement claim for the bill items which are under the healthcare policy.

Accurate billing including the use of appropriate coding
Theoretically and on paper healthcare reimbursements from medical insurance companies seem like a piece of cake. It is all laid out in black and white and they promise to make a payment within a certain specified number of days. But when you get into the intricacies of the claim process, it is a different picture altogether. Nothing is as simple and easy as it is supposed to be.

Before filing a reimbursement claim the medical services or provision needs to be categorized and coded. We have a specific team of people who are trained in medical coding. A code is not just a random combination of characters. A medical code reveals a lot of information about the patient including the diagnosis, the current condition of the patient, the type of treatment, medication, equipment used for the treatment. Assigning the right medical coding to the claim submission is an integral step towards faster reimbursements.

Dealing with claim errors and denials
Claim denials are not uncommon but need to be resolved tactfully. Delays in dealing with claim denials could lead to a monetary loss for the healthcare organization. AllianceMed has particular people assigned to handle the claim denials and sort of the issues. In so doing we are able to speedy up the claim submission process.

The success of a healthcare organization rests in focusing on providing medical services and outsourcing other related services to specialized companies. AllianceMed is a healthcare billing company specialized in providing end to end revenue cycle management services with an emphasis on increasing revenue.

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