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We understand that healthcare providers have enough on their plate without having to worry about verifying patient eligibility and benefits. That’s why we offer a comprehensive service to handle this process for them. Our team of experts is dedicated to ensuring timely payments and a stable Revenue Cycle for healthcare providers. MBP Billing and Coding Solutions understands the importance of verifying patient eligibility and benefits before providing services. In fact, up to 75% of claim denials are due to patient ineligibility. Our comprehensive service is designed to help healthcare providers streamline the process and avoid unexpected financial surprises for patients.
Health care is a basic human right that everyone must use at some point in their lives. Important parts of the healthcare system are the Verification of Benefits (VOB) and Prior Authorization (PA) procedures, which guarantee that patients receive essential medical care while reducing the possibility of denied claims and rejections from insurance companies. MBP Billing and Coding Solutions offers complete Verification of Benefits (VOB) and PA services to assist healthcare providers in providing seamless medical care to their patients.
The VOB process is an essential initial step in the medical care process. Finding out whether a patient is eligible for a particular medical service or treatment and whether their insurance covers it requires a few steps. The following procedures are followed by our team of experts at MBP Billing and Coding Solutions to guarantee a flawless VOB process:
The initial phase of the VOB procedure entails gathering patient data, which encompasses insurance details and medical background. To prevent errors in the procedure, our staff makes sure that all patient data is precisely gathered and validated.
The following action involves confirming that the patient is qualified for and has insurance for a particular medical service or treatment. This step involves figuring out the patient's deductible, coinsurance, and copay.
After the patient's eligibility and coverage are established, the VOB request is sent to the insurance provider for approval. Our team makes sure that all patient coverage information is precisely verified and documented to prevent any problems during the billing process. To prevent any delays in the medical care process, our team makes sure that the VOB request is submitted on time.
VOB is crucial for healthcare providers because it helps to prevent miscommunications between the healthcare provider and the patient. It guarantees that the patient is aware of the limitations of their coverage as well as any potential out-of-pocket expenses.
This procedure is a vital part of the medical care process that establishes the suitability and medical necessity of the suggested treatment or service. The procedures listed below are how our staff at MBP MBP Billing and Coding Solutions makes sure the PA process goes smoothly:
Gathering patient data, such as medical histories and treatment schedules, is the first step. To prevent errors in the procedure, our staff makes sure that all patient data is precisely gathered and validated.
The suggested treatment or service's medical necessity and appropriateness are examined in this step. Our team of professionals guarantees that the suggested course of action or service is both medically necessary and suitable for the patient's condition.
Following the determination of both medical necessity and appropriateness, the PA request is sent to the insurance provider for approval.
Lastly, the insurance company will provide approval or denial of the PA request. Our team makes sure that the PA request is submitted as soon as possible to prevent any delays in the medical care process. To guarantee prompt approval, our team of specialists keeps a close eye on the PA request's progress and follows up with the insurance provider.
These procedures minimize the likelihood that an insurance company will reject a patient's requested medical care while guaranteeing the extent of coverage for that treatment. Prior authorization guarantees insurance provider coverage prior to the recommended course of treatment. MBP Billing and Coding Solutions assists healthcare providers in providing their patients with high-quality care by offering Verification of Benefits and Prior Authorization services. In order to help healthcare providers improve patient satisfaction, our skilled team takes the necessary steps to guarantee the completion and accuracy of these services. Every patient's benefits are verified by our professionals, who carefully confirm their coverage, co-pay, coinsurance, and related costs. We work to record accurate information to support proper treatment plans and communicate financial responsibilities by carrying out thorough checks.
As your trusted partner in Revenue Cycle Management, MBP Billing and Coding Solutions empowers you to potentially increase your Medical Billing revenue by up to 30%. Our dedicated 24/7 customer service ensures exceptional patient care, free from worries regarding delayed payments or ongoing training. With extensive experience of more than 18 years in the healthcare sector, we excel in generating clean claims and encounters, achieving an outstanding claim acceptance rate of 99.9%. Our efficient procedures minimize claim processing times, leading to cost savings. Moreover, we actively pursue old Accounts Receivable (A/R) claims and prioritize the prompt submission of clean claims to accelerate your revenue cycle.
Precision in Medical Billing and CredentialingMBP Billing and Coding Solutions stands out as a renowned provider in the medical billing service industry. Our reputation is built on consistently delivering precise and prompt outcomes, which effectively boost revenue for our valued clients. Utilizing cutting-edge technology and expertise, we streamline the billing process, reduce errors, and enhance productivity, all while delivering exceptional client support. Our team at MBP Billing and Coding Solutions comprises highly skilled and extensively experienced specialists in Medical Billing and Coding. Beyond simply managing billing requests, our commitment lies in passionately ensuring your economic prosperity in the Revenue Cycle Management Sector.
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We are helping healthcare physicians across the United States tackle their medical billing and credentialing challenges. Our team of experts specializes in key areas known for significantly improving billing efficiency and accuracy. If you're seeking a reliable medical billing company, look no further. Contact us today to learn more about our comprehensive services!
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"MBP Billing and Coding Solutions has been a game-changer for my practice. Their expertise in managing credentialing and billing processes has allowed me to focus entirely on patient care. Their team is incredibly reliable and always ready to assist. Highly recommended!"
"Working with MBP Billing and Coding Solutions has significantly streamlined our billing processes. Their proactive approach and meticulous attention to detail have resulted in faster reimbursements and reduced administrative burdens. Their services are indispensable to our clinic."
"The team at MBP Billing and Coding Solutions is exceptional. They handled our credentialing and contracting with such efficiency that we experienced no downtime. Their dedication and professionalism ensure our practice runs smoothly, and we couldn't be happier with their services."
"I can't thank MBP Billing and Coding Solutions enough for their outstanding service. Their regular follow-ups and audits have kept our credentialing up-to-date and compliant. Their expertise has saved us time and money, making them an invaluable partner for our office."
"MBP Billing and Coding Solutions has exceeded our expectations in every way. Their comprehensive understanding of the credentialing process and prompt handling of contracting issues have been crucial for our practice. Their support allows us to maintain our focus on delivering excellent patient care."
Common QueriesPatient Verification of benefits (VOB) is the process of verifying a patient's insurance coverage and benefits for a specific healthcare service or procedure. This is important because it helps healthcare providers determine whether a patient's insurance plan will cover the cost of the planned treatment or procedure, and if so, what the patient's out-of-pocket expenses will be.
Prior Authorization (PA), also known as pre-authorization or pre-certification. Prior authorization (PA) is the process of obtaining approval from a patient's insurance provider before providing a specific service or procedure. This is important because it helps to ensure that services are covered under the patient's insurance plan and that the patient is aware of their financial obligations before they receive the service or procedure. PA is typically required for certain types of services and procedures, such as:
Verification of Benefits (VOB) and Prior Authorization (PA) are two distinct processes in the healthcare industry, each serving a unique purpose. Here's the key difference between VOB and PA:
Verification of Benefits (VOB)
Purpose: VOB is the process of verifying a patient's insurance coverage and benefits for specific healthcare services or procedures. It helps determine the extent of a patient's insurance coverage and their financial responsibility for a particular medical service.
When It Occurs: VOB typically takes place before a healthcare service or procedure is provided. It is essential to understand the patient's coverage to ensure accurate billing and transparency regarding financial responsibilities.
Key Focus: VOB focuses on confirming the extent of a patient's insurance coverage, such as deductible amounts, copayments, coinsurance, and out-of-pocket maximums.
Parties Involved: The primary parties involved in VOB are the healthcare provider's administrative staff and the patient's insurance company.
Prior Authorization (PA)
Purpose: PA is the process of obtaining approval from a patient's insurance company before certain healthcare services, treatments, procedures, or medications can be provided. The primary aim of PA is to ensure that the proposed healthcare service is medically necessary and complies with insurance company policies.
When It Occurs: PA occurs before specific healthcare services or treatments are administered, and it focuses on ensuring the necessity and appropriateness of the proposed care.
Key Focus: PA focuses on evaluating the medical necessity and appropriateness of the requested healthcare service based on insurance company criteria. It aims to control healthcare costs and maintain quality care.
Parties Involved: The parties involved in PA typically include the healthcare provider, the patient, and the insurance company
VOB and PA are important because they help to ensure that patients receive the services they need and that healthcare providers are paid for the services they provide.
VOB (Verification of Benefits) is important because it helps to ensure that patients are aware of their insurance coverage and benefits before they receive a service or procedure. This can help patients to avoid unexpected financial surprises.
PA (Prior Authorization) is important because it helps to ensure that services are covered under the patient's insurance plan and that the patient is aware of their financial obligations before they receive the service or procedure. This can help to reduce denials and delays in payment for healthcare providers
Resolving Verification of Benefits (VOB) and Prior Authorization (PA) denials can be a complex but necessary process in healthcare. Here are steps to help resolve denials effectively:
You can find more information about Verification of Benefits (VOB) and Prior Authorization (PA) through various reputable sources. Here are some places to explore for in-depth information
A Verification of Benefits in Medical Billing is typically performed prior to providing medical services or at the beginning of a patient's treatment to ensure eligibility and coverage details with the insurance company
The duration of a Prior Authorization process can vary depending on several factors, including the complexity of the procedure, the specific requirements of the insurance company, and the responsiveness of healthcare providers. In general, it can take anywhere from a few days to several weeks to obtain approval for a prior authorization
Yes, Medicare does require Prior Authorization for certain services, procedures, and medications. Prior Authorization is necessary to ensure that the treatment or medication is medically necessary and meets Medicare's coverage criteria. It helps prevent unnecessary expenses and ensures appropriate utilization of resources. However, not all services or medications require Prior Authorization under Medicare, so it's essential to check with your healthcare provider or Medicare plan for specific requirements.
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MBP Billing and Coding Solutions offers expert medical billing services to optimize revenue and streamline operations for healthcare providers.
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