Medical Billing – Tips For Large Companies and Medical Stores

Medical Billing – Tips For Large Companies and Medical Stores

Medical Billing,Today, most of the Medical Billing that is done is done by very large companies. While this may seem more efficient and certainly more profitable to their customers, there are many pitfalls that a large company can fall victim to.

The first and probably most important thing, is for the company to set itself up in such a way as to maximize productivity and at the same time minimize the risk of running into serious problems. One way to do this is to divide the Medical Billing responsibilities up among departments.

The next thing you’re going to want to do is setup your software in such a way that it allows for growth without having to worry about your network getting bogged down. This is probably the most complicated part of the process of setting up an operation.

Possibly have one database for patients and facilities from A to M and another database for the letters N to Z.This will need to be done for all databases in the system.

As you have broken down the databases, you’re probably also going to want to break down the staff as well, having half the staff take care of all patients from A to M and the other half taking care of patients from N to Z.

Helpful hints to reduce claims processing time

• Submit claims electronically. ODS processes electronic claims first each day.
• Verify the patient’s relationship to subscriber and plan information is correct before submitting claims.
• Include all pertinent information. Date of birth, subscriber ID, valid CPT and ICD-9 codes.
• If the patient is covered by more than one ODS program, submit one claim form indicating the name of the subscriber, subscriber ID, employer (if applicable), and ODS group number for both plans.
  

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• If covered by another carrier, indicate the above information plus the name, address and policy number of the other carrier.
• If a patient has primary insurance through another carrier other than ODS, the EOB from that insurance company will need to accompany the claim for consideration of payment.
• ODS makes payment twice per month.
• Please contact before submitting duplicate claims:
  

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  • Re-billing without contacting us slows our turnaround time and delays payment.
  • Check Benefit Tracker to see the status of a claim. If you haven’t registered for this free online service, click here for more information.
  • If you receive a PDR indicating that your claim has already been processed before you receive a check, this indicates your re-bill was unnecessary. The claim was processed and is pending for the next scheduled payment date.
• DO NOT USE HIGHLIGHTER ON PAPER CLAIMS.

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