What are the two most common types of medical billing?

Managing the medical billing process is quite challenging for healthcare providers and patients to handle the payment process. The real-time attention towards payment submission and claims for healthcare insurance companies may demand more time and energy. You have to ensure all the financial flow with your healthcare services can be stimulating for any practitioner to manage. The medical billing process can help you manage it and track revenue flow. Let me share the types of medical billing, medical billing options, medical billing strategies, medical billing methods, and approaches to medical billing.

Types of Medical Billing

Healthcare uses the two most common types of medical billing in their department: professional billing and institutional billing.

Professional Billing

Individual healthcare practitioners use the professional billing method for their healthcare services. It is helpful to manage the payment with patients and insurance companies in private clinics. CPT is known as “Current Procedural Terminology” used in professional billing.

Institutional Billing

Institutional Billing Healthcare Common Procedure Coding System is the medical billing code used for institutional hospital billing for service.

Medical Billing Options

When it comes to the options available for medical billing in the healthcare department, there are three most common ones.

1. In-House Medical Billing

2. Outsourced Medical Billing

3. Hybrid Medical Billing

In-House Medical Billing

Managing the healthcare medical billing in the organization is referred to as In-House Medical Billing. It is a good-to-go option for handling medical billing for the developed infrastructure. Healthcare organizations can have full access to control the billing process and customize the software it as required to manage.

Outsourced Medical Billing

The third party will manage the medical billing process on behalf of the healthcare organization under the outsourced. Organizations with many healthcare services can use this option for their medical billing to manage the resource. As a healthcare department, you will get a customized solution for medical billing requirements per their codes to manage the bills effectively.  Outsourcing is an excellent option to save time and expense, managing and controlling the cash flow while focusing on your patient.

Hybrid Medical Billing

This hybrid medical billing option is suitable for managing healthcare processes and billing. You can access the billing process while outsourcing it and manage it with a third-party vendor to manage it with the organization.

Medical Billing Strategies

To maximize the revenue for healthcare services, you can use medical billing strategies to increase the profit and manage the denial.

1. Insurance Verification

2. Claims Submission

3. Patient Billing and Collections

4. Denial Management

5. Payment Posting

6. Revenue Management

Insurance Verification

This process verifies the patient’s eligibility for verifying patient insurance coverage before moving towards rendering services. Ultimately, it helps to avoid claim denial for patients who are not eligible for insurance. You can choose to automate the system for verification to save time.  

Claims Submission

This strategy helps to check the claims submission to avoid any error from the insurance company. It helps to manage the claims submission from insurance companies with an automated system. A healthcare organization can save time by avoiding claim denial before moving toward further procedures.

Patient Billing and Collections

This strategy helps manage the patient billing and collections process per insurance company requirements. It refers to managing the claim denials against non-registered patients. Technology saves time by automating the systems to manage all the processes.

Denial Management

To avoid claims denial this strategy helps to take action for future concerns. Healthcare providers use this process to identify the cause of such claims and implement solutions like denial management to avoid further issues.

Payment Posting

Healthcare organizations can track the record of the payment process for patients from insurance companies. Such a technology strategy helps keep the process faster and saves time to avoid discrepancies.

Revenue Management

The revenue process can be identified using a revenue management strategy in healthcare departments. Healthcare practitioners can save time with the implementation of the revenue management system. Further, they can keep a track record of revenue in each department of patient cases.

Medical Billing Approaches

There are different medical billing approaches to manage the medical billing process as per requirements. Such as:

1. Fee-for-service billing to control the medical billing process in healthcare organizations, but it can take time and demand more investment in the system.

2. Capitation Billing is used for the fixed service charges no matter the patient’s health case. Thus, it can be risky to estimate the revenue per case.

3. Bundled Payment Billing provides a fixed amount to be charged to the patient. It helps them to predict the revenue in a period. Healthcare practitioners can coordinate with patients to streamline the revenue for a group of services in a package.

4. Value-Based Payment Billing variations for incentives to maximize the quality of care and the oriented payment service for patients. This approach helps keep a track record of reducing costs and increasing service quality.

Managing medical billing is demanding in this era to control the payment flow and provide quality patient service. Thus, these medical billing options and strategies help to increase the quality of care service with optimized solutions for revenue management. American MBS offers you quality medical billing solutions to improve the revenue cycle and help avoid the risk of claims denial.

Also Read: Top-Rated Medical Billing Services in Florida

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