Charge Entry process is a critical step in the Medical Billing Cycle; it is critical that this scope of services is handled by experts who are up to date on the payor fee schedule for the service rendered. For increased reimbursement, the charge entry process should be an essential part of daily billing. Let’s talk about how to Optimize Charge Entry to achieve your financial goals.

Potential Pitfalls in the Charge Entry Process

Processing Fee Entry without errors or mistakes is a challenge for any billing team because even a typo or inadvertent miss can result in significant financial loss. Billers are frequently unaware of insurance policy changes and updates; being unaware of fee value changes and continuing to bill for old charges results in revenue loss.

Obtaining Quality in Charge The entry process is only possible if the following steps are followed correctly:

• Documentation of the physician’s treatment that is clear and complete. All billable services must be documented in the medical report by the physician in order for billers and coders to enter appropriate Medical Codes and Charges to be claimed from the payor.
• To meet internal quality standards, eliminate likely data entry errors and mistakes.
• Allocate a trained and experienced team to handle major services such as charge entry.
• Keep an eye out for policy updates or changes to the fee schedule from the Centers for Medicare and Medicaid Services (CMS).
• Allow a dedicated audit team to audit a portion of daily workflow to ensure quality and compliance standards are met. In addition, any repeated errors or flaws in process flows must be captured and reported.

With a Medical Billing expert handling complete Revenue Cycle Management Services optimizing Charge Entry or other scopes of services, all parties involved can achieve maximum reimbursement and financial growth.

About WWS

WWS is one of the leading Offshore Medical Billing Companies in India, promising to avoid claim rejections and denials with our expertise and experience. With decades of experience in Medical Billing and Revenue Cycle Management Services, our team guarantees maximum monthly collection through an optimized Charge Entry process.

Benefits of Outsourcing Charge Entry Process

Outsourcing charge entry to a third-party Medical Billing Company results in improved quality and a higher reimbursement percentage. A few advantages of Offshore Outsourcing Charge entry and other RCM scopes are listed below.

Avoid time lags because the offshore crew is available 24 hours a day, 7 days a week, and handles the majority of the data entry work during the night hours in the US, allowing for speedier claims processing. 

Regular audits aid in identifying areas that effect collection percentages and educating the charge entry team to be more careful. It also aids in the detection of errors in medical report documentation.

Remove from the equation Control and correct frequent denials that stem from the same source.

One of the biggest challenges, which also has a direct impact on the revenue collection of most practices, is credentialing i.e. enrolling with the best insurance service provider. This is not really as simple as it sounds. With so many insurance providers having opened shop, it is not easy to tell which one would be the best for a particular medical practice. No wonder then that most practices prefer to outsource their credentialing services as this would mean one less thing to worry about.

Are you still indecisive about whether to outsource your medical credentialing?

Well, take a look at these pointers which will help you understand when the time is right to outsource your practice’s the credentialing process.

1. Big process

Collecting the necessary details from the patient and other stuffs are a big process which should happen flawlessly. If the billing service staff is employed to collect all these details then it is pretty hard for that single employee to take care of all such things. So it is better to connect with insurance service provider.

2. Lessen your burden

When you take a step forward by implementing software and appoint an insurance provider employee for claiming reimbursement then it becomes an easy task for everybody. Every employee will have his own work to do. The number of workforce will also be increased along with that the technology will also be implemented.

3. Experts on role

If your healthcare industry is less experienced in such insurance stuffs leaving them in experts hand can lead to no denials or rejections of claims. Experts will do their job professionally and minimize the risks of rejections in claims.

Here, you will find our Step-by-Step Physician Credentialing Process

1) Week 1 Strategy and Information Gathering

a) During the first ten days or so after signing an agreement, our team will work with you to massage your payer list and ensure all relevant payers are included.

b) In addition to the payer review, your account manager will work with you to ensure we have everything needed to submit and process your applications.

2) Weeks 2-5 Application Submission & Follow up

a) During this time we will contact all insurance companies and begin the application process.  Some of them require an LOI (letter of interest) and others want you to submit a form on their website.  Regardless of how they do it, we will take care of all of this.

b) Once the requests to join the network have been submitted, this is when the follow-up process starts and continues until everything has been finalized.

3) Weeks 6-9 Follow-Up & Contracting

a) During this period we will continue to follow up and should begin to see your application making it through the payers credentialing process.

b) Once your application has made it through the initial process, we will now ensure it transitions smoothly into the contracting phase.

4) Weeks 10-16 Contract Negotiations & Effective Dates

a) This is when things start to get fun.  Agreements are coming in and you’re beginning to see some results.  Payer agreements are reviewed and submitted to you for signature (if they don’t need to be negotiated).  Once signed, these executed agreements are returned to the payer for loading.  The loading process with some payers can take an additional 30-45 days.

b) Finally, we will work through your payer list and ensure we have effective dates and provider IDs for all applicable payers.  We will then work with you to provide this information to your billing company or department.

EndNotes:

Outsourcing your credentialing is the equivalent of a primary care physician referring to a cardiologist when a patient presents with an irregular heartbeat. While the primary care physician could very likely handle the problem internally, is the risk of missing something serious really worth it? That’s really what you must ask yourself. Based on national credentialing surveys, the average time for a physician to be credentialed by a group is 180 days whereas most of our payers are completed in 90 days.  Is finishing the process faster and more accurately important to you? If it is, we believe you’ll reach the logical conclusion that outsourcing is the answer.

If you have any questions write us @  support@wonderws.com   or Schedule a 30 minute Complimentary live demo on our customized credentialing solutions.