3 Tips To Improve Your Specialty Medical Billing Practices

1 November 2021
 Categories: Finance & Money, Blog


Specialty medicine is big business. Patients are referred to specialists every day for further testing and advanced diagnostics.

Medical specialists face unique challenges when it comes to billing patients for their services. There are specialized codes reserved for each medical specialty, and insurance companies may require more documentation to support a specialty medical claim.

While some billing factors are out of your control, here are three tips that you can use to improve your specialty medical billing practices in the future.

1. Always Verify Insurance Coverage

It's not uncommon for patients to switch health insurance providers. This is why it's important for office staff to verify insurance coverage for each patient checking in for a specialty medical appointment.

It only takes a few moments to verify a patient's coverage, and these moments could save you months of stress when trying to receive payment for specialty medical services in the future.

2. Study and Understand EOB Forms

All health insurance carriers are required to furnish medical offices with explanation of benefits (EOB) forms. These forms outline the types of coverage the carrier provides and the payments that will be made on behalf of the patient for each medical service your clinic offers.

It's vital that all employees involved in specialty medical billing take the time to study and understand EOB forms. This understanding will make it easier for employees to avoid coding discrepancies that could delay payment.

An understanding of EOB forms can also help employees spot unnecessary insurance downcoding or bundling that reduces the amount an insurance company is willing to pay.

3. Consider Outsourcing

Specialty medical billing requires a lot of time and attention to detail. Claims should be processed and submitted to insurance carriers on a daily basis, and all payments received should be reviewed and compared against EOB forms to ensure accuracy.

Handling these billing tasks in addition to all other clinic administrative tasks can be overwhelming for office employees. Outsourcing your specialty medical billing to a company that is dedicated to the task can be an effective way to minimize billing errors and payment delays that could compromise the viability of your medical practice.

Medical billing is a complex and labor-intensive task. Specialists face even more challenges when it comes to billing for the services they provide. It's important that you are being proactive in improving the way your specialty clinic handles its medical billing tasks to guarantee your success.


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