Many physicians and other health care professionals turn to medical management services to assist them with running their practices. Medical management services can perform many different functions for health care professionals. These can include medical call center services, utilization management, claims cost management, and independent physician review and consulting. Medical call center services can provide trained, professional staff at a call center that answer telephone calls, and are supported by clinical information databases. Utilization management is a process for monitoring the use and delivery of services, for example by performing pre-certification and pre-authorization via clinical review, surgical review, and outpatient medical review.
Medical management services handle the bills and claims for hospitals, clinics, doctor’s offices, or health insurance companies to ensure that bills are correct and claims are valid. This can save a clinical hospital or healthcare facility money in the long run by weeding out incorrect or bogus claims, and by streamlining billing services to ensure smoother operations. Medical management services may provide electronic processing, transcription, web-based medical billing software, electronic medical records (EMR), patient database management, forms, staffing organization, insurance claims, coding, customized online charge slips, health and wellness promotion programs, payment and remittance posting, advanced appointment scheduling, patient billing inquiries, visit tracking, collections, denial tracking, reporting, fee schedules, and management of financial books.
If you are a physician, doctor, or therapist in need of the above services, consider hiring a medical management service or contractor for your needs, whether you need assistance with billing, coding, staffing, clinical records management, or insurance claims. Some medical management services simply provide billing solutions, while others provide a broad spectrum of services. Go online to research what a medical management service typically offers, industry rates, company backgrounds, and contact information for local companies in your area. If you wish to pursue medical management as a career, check out online job banks to find the right job for you. Or, check out area colleges or universities to find out about classes and online courses on medical management. If you are a health care facility, clinical hospital or doctor’s office in need of assistance with anything from claims management to transcription to billing to coding, medical and healthcare management services can help.
Companies that don’t have the time or resources to handle their billing requirements, can hire a medical management service to perform this task. Hospitals, doctor offices, medical centers, and clinics can all contract with a medical management service to take care of all bills, records and claims for them. They not only send and receive bills and payments, but they also ensure that patient bills are valid and up to date, along with insurance claims. These companies are located online but also may have an office where employees perform their jobs. They are outside companies hired by physicians and hospitals to take care of anything from transcription to form filing to bill processing.
Hiring a medical management service saves companies not only time, but also money, as they don’t have to employ staff in house to perform these tasks. This allows them to direct their focus elsewhere. Streamlined operations are at the forefront of this concept, with medical management teams helping to identify and correct invalid claims, organize files, and ensure that patients pay their clinic bills on time. They can set up payment plans, as well as provide electronic processing, coding, and payment and remittance posting. An initial consultation may take place at the facility or over the phone to outline goals. Other companies specialize in selling user-friendly medical management software systems, designed for use in the healthcare community. Such software can help process claim payers, including insurance carriers. Medical management services offer tools, models, and solutions to a healthcare facility for efficient records and data management through web-based physician billing and other programs.
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