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Billing Operations Evaluation

Understanding every step of the medical billing process is crucial to ensuring maximum payment for provider services. Unlike billing for office-based medical specialties, emergency medicine, urgent care, and hospitalist billing are unique given their episodic nature, and are best evaluated using the specialty-specific benchmarks and criteria we have collected over 15 years in the consulting industry. Evaluation of billing and collection processes requires a detailed review of back-end billing processes including:

  • Pre-billing
  • Physician credentialing
  • Encounter tracking
  • Invoice generation
  • Collection processes at the billing agent.

Billing Reports Review

BSA Healthcare’s billing reports review service was designed to facilitate a reduction in errors in billing and accounts receivable management processes. Whether medical billing is performed in-house or through an outside agent, almost all billing organizations run monthly summary reports. Though the terminology and format of these reports varies, the functions they quantify typically include a summary of monthly charges and payments by payer class, aged trial balances, patient encounter acuity and procedure analysis, and quantification of collection rates. 

Review and analysis of these reports will ensure that you are collecting legitimate revenue for provider services. Using specialty-specific criteria and proprietary billing benchmarks, BSA Healthcare can help identify and correct process pitfalls.