Running a medical practice in Texas can be challenging, especially when it comes to handling complex state regulations. Texas healthcare regulators have their own rules, including medical costs and insurance requirements. In fact, a report by the Texas Medical Association highlights that healthcare practitioners find tackling these complex regulations most challenging, adding to the list of major challenges facing the state’s healthcare system.
To overcome these burdens, it’s best to outsource medical billing services in Texas to qualified medical experts. The Black Book Market Research report found that 82% of medical practices that outsourced their medical expenses saw revenue increase in the first six months. This post delves into the typical issues Texas healthcare providers face regarding medical billing and how teaming up with a medical billing company in Texas can help ease this load.
Challenges of Medical Billing for Texas Healthcare Providers
The healthcare system in Texas is undergoing rapid transformation. Providers must address multiple barriers to medical affordability. The main challenge is that laws change constantly, and it can be difficult to keep track of all the complex rules. A recent study by The Medical Group Management Association (MGMA) estimated that Texas medical practices are losing up to 5% of their revenue due to billing errors and rising state healthcare costs, and even small losses can have a significant impact on a facility’s bottom line.
To address these challenges effectively, healthcare providers in Texas must adopt proactive strategies and innovative solutions. Here are some common challenges that healthcare providers in Texas are facing and seven ways to overcome them:
The Ever-Changing Compliance Regulations
It is a constant race to stay informed of updates to federal and state healthcare laws, coding systems (like ICD-10 and CPT), and payer-specific policies. A 2023 study by the AMA found that 72% of physicians reported difficulty keeping up with changes in medical coding and billing regulations. Missing even minor details can lead to larger claims being denied and delayed, affecting your practice’s revenue.
Time-Consuming Processes
Medical billing services in Texas involve many steps and are considered to be a complex process, from accurate patient information and coding to claim submission and follow-up. These processes consume valuable time that healthcare professionals could be dedicating to patient care.
Lost Revenue Potential
Non-compliant or misplaced billing can result in a claim being denied, wasting revenue potential. Expert medical billing services in Texas have extensive knowledge of medical coding and insurance claims, so they can file billing claims accurately and efficiently and likely receive the maximum reimbursement.
Claim Denials
Claim denial is when insurance companies refuse to pay for medical expenses. This could be due to coding errors, missing data, or procedures not described in the patient’s chart. These denials delay your practice’s income and require additional work to resolve.
Battling AR Backlogs
A 2023 report by the Texas Hospital Association (THA) revealed that the average number of days in AR for Texas hospitals is 95 days, exceeding the national average of 80 days. A large volume of claims pending payment for a long time can be very demanding for your practice’s bottom line.
Security and Data Privacy Concerns
Patient privacy is paramount in healthcare. Billing errors can have financial implications, as well as compliance issues and patient dissatisfaction. Medical billing companies invest heavily in secure technology and adhere to stringent HIPAA regulations to protect sensitive patient data.
Lack of In-House Expertise
Hiring and training qualified medical billing staff can be a significant investment for smaller practices. The administrative burden of managing payment processes internally can also divert valuable time and resources away from patient care.
Staying Ahead of Technological Advancements
New technology is being introduced every now and then in the healthcare industry to make billing error-free. Smaller practices often lack the resources to keep pace with the rapid adoption.
Seven Valuable Benefits of Outsourcing Medical Billing Services in Texas with Us
At Transcure, we integrate medical billing services that are custom-made to meet the unique requirements related to healthcare regulations in Texas. We offer comprehensive medical billing services in Texas that cover all the key areas targeted at improving the revenue cycle and reimbursements. Here’s a detailed explanation of the billing services we specialize in:
- Precise Data Entry of All Charges
Data entry, in which incorrect data input is the fundamental flaw, is the foundation of efficient medical billing. The billers in Transcure maintain highly accurate documentation of all charges involving patient visits, procedures, and any service given by healthcare providers. Thus, tracking perfect records is key to the ultimate claim processing purposes and revenue generation.
2. Error-Free Submission of Electronic and Paper Claims
We improve the claims submission process by using RPA technology to send electronic claims to insurance companies without errors. Furthermore, we also take care of processing and transmitting paper claims that are consistent with the payers’ requirements and rules. Our target is to have a fast-track reimbursement in place and ensure limited delays in the payment process.
3. Proactive Tracking and Follow-Up on Unpaid Claims
Unpaid claims can result in an adverse impact on the financial performance of a healthcare provider as they may directly affect their cash flow and revenue stream. Our RCM billing services in Texas have implemented a preventive approach to handling claims. This involves tracking and reporting status and prompting issues and discrepancies. Our dedicated staff, following closely on all the accounts receivable, will pursue and rectify all the claims not paid on time.
4. Personalized Preparation of Patient Statements
Clear and transparent communication with patients is the key factor that needs to be considered in the payment process, as well as preventing any overdue balances. Our team of professionals craft patient statements in a way that is easy to understand and will explain the nature and cost, insurance coverage, and responsibilities on the patient’s side. By fostering patient understanding and engagement, we promote compliance and reduce delinquencies.
5. Accurate Payment Posting
A proper payment posting system is vital for effective account reconciliation and consistent financial record maintenance. Our team is responsible for the timely and accurate posting of payments from insurers and patients. We have tightened our reconciliation processes against errors and incompliant transactions to track revenue streams and identify any anomalies promptly.
6. Tailored Billing Reports for Informed Decision-Making
We agree that data-driven reasoning is the key to achieving revenue cycle management. Our customized billing reports offer an overview of the most critical performance metrics, such as claims status, reimbursement volume, and future revenues. Data analytics in healthcare consists of collecting and analyzing data on health services to help in decision-making and carry out strategic improvements.
7. Timely Updates on Payer Fee Schedules
Understanding how much insurance companies will pay for various services is helpful for managing healthcare costs. Our medical billing experts stay on top of insurance regulations to make sure you get what you deserve. Transcure billers stay up-to-date with all the latest updates to ensure accurate billing. By being constantly alert and responsive to the changing policy landscape, we assist our clients in keeping abreast of the dynamic changes in healthcare.
Overcome Medical Billing Headaches in Texas with Transcure
Are complicated medical billing laws and managing insurance regulations wasting your time and resources? Our medical billing company in Texas understands the unique challenges healthcare providers face. Don’t let medical billing become a burden that prevents you from providing exceptional patient care. Outsourced medical billing services from Transcure can streamline your billing process and improve cash flow.
Here’s how our medical billing services in Texas can transform your practice:
- 99% Accurate Claim Submissions: Our RPA technology ensures claims are nearly accurate, reduces denials, and maximizes reimbursement.
- Complimentary AR Recovery & Quick Payments: We recover unpaid claims within 24 days and get quick payments from insurers in just 26 days.
- 20% Revenue Increase: We support Independent Physician Associations (IPA) in recovering lost revenue and maximizing reimbursement by 20%.
- Frictionless Workflow: We handle everything from credentialing to claim submissions, freeing your staff to focus on what matters most – your patients.
- Security and Accuracy: We prioritize security concerns, ensuring compliance with Texas State Law, HIPAA, ISMS, SOC, OIG, and all mandatory guidelines.
Frequently Asked Questions (FAQ)
Are medical expenses tax deductible in Texas?
Yes, medical expenses are tax deductible in Texas if they exceed a certain limit of adjusted gross income (AGI). Expenses above 7.5% of AGI are deductible. This includes expenses such as doctor visits, prescriptions, and certain medications. However, it is best to consult with a tax professional for specific information and eligibility criteria.
What is the statute of limitations of medical billing in Texas?
The statute of limitations for medical expenses in Texas is generally four years from the date of submission. This means that medical providers have up to four years to pursue legal action to collect unpaid bills. However, there may be exceptions based on factors such as the type of treatment provided and when the cost was discovered.
Is medical billing taxable in Texas?
Medical billing services in Texas are typically not taxable. However, medical professionals’ services, such as surgeries, consultations, medications, and medical equipment, may be subject to sales tax unless specifically excluded. Physicians and patients should consult a tax advisor if they need to clarify taxes under the relevant laws for their particular circumstances.
