An administrative services enterprise with HIPAA-compliant procedures, New England Medical Billing emphasizes a multi-disciplinary approach to system and program design. As featured in the New England Medical Billing blog, one major area of the firm's focus is in ensuring accuracy and efficiency through capturing the correct patient demographic and insurance information.
Common reasons for incomplete data include typos and misspellings, as well as emergency situations in which the patient is unconscious and there is no way of obtaining information such as his or her name or birth date. The emphasis, as it should be, is on providing timely care that may ultimately save a life.
Unfortunately, this situation can lead to major issues down the road, as municipalities contend with lack of information when submitting claims to insurance providers. This in turn often leads to denial. A “self pay” designation is not ideal either, as reimbursement rates for self-payers can be much less than those provided under “fee-for-service” designations.
A best practice involves billing vendors working toward the best interests of municipalities in creating IT-integrated relationships with local hospitals. This process ensures that data is entered directly into hospital health information systems, with information gaps being addressed the moment they occur and the direct billing of patients only taking place in cases of last resort.
