Sometimes, It’s Just Amusing

Medical Billing

Several times over the last couple of years I have talked with a pediatrician who needs help with his practice. On each occasion he has come to the point of making a decision that can only benefit him and his practice and he becomes frozen by the thought.This week while having lunch with a representative for one of the major insurance providers in the state I was told of the dire circumstances this particular practice is in. They are lost and do not know what to do. Their medical billing is in a mess. They allow filing limits to pass and do not understand why they cannot get their claims processed. These are really very simple issues, but they still paralyze the practice.Further in our lunch conversation, another practice came up. In discussion of that practice the representative said the practice no longer even posts the EOBs to their charges. They do not know how to make the system work. Can you imagine the mess that system must be in? How do they bill the patient for their part of the payment? Are they just writing it off? If so aren’t they in violation of their agreement with the insurance companies not to mention the possible fraud status with Medicare? How do they even know what has been paid, what has been underpaid, what has been ignored?How do things get this way? It’s easy! Providers cannot do everything any more than any other professional. Unless the provider is willing to contract with a qualified entity to do that work, they will continue to suffer from underpayment, no payment and complete inefficiency. Competent medical billing companies do not cost a practice any revenues. They generate revenues for the practice. If they do not, they are the wrong medical billing company! When you hire the right medical billing group, it is almost as if they are paying you for the privilege of collecting your money for you.

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