Selecting the right medical billing company is key to ensuring smooth claim processing, optimal reimbursement, and an improved bottom line. As the healthcare revenue cycle becomes more complex, outsourcing to specialists is an increasingly attractive option. In this article, we’ll explore why Medwave rises above the rest as the top medical billing service for providers.
Deep Medical Billing Expertise
Medwave employs dedicated teams of credentialed medical billing and coding experts with an average of over 10 years industry experience each. Our proficiency spans the full revenue cycle – from verifying eligibility and benefits to final payment posting. Years navigating complex payer policies equips them to achieve both clean claim rates and first-pass resolution ratios exceeding industry averages. Our rigorous training curriculum and continuing education ensure staff are constantly up-to-date on the latest protocols, guidelines, and system workflows essential for billing success.
All Source EHR Platform Expertise
Medwave’s teams are well-versed in all major electronic health record systems including Epic, Cerner, eClinicalWorks, NextGen, athenaHealth, Allscripts, Meditech, and more. Our insight into EHR data structure and capabilities allows seamless integration for automated eligibility checks, coding recommendation, rules-based claim compilation and more. This reduces manual work while boosting compliance. Robust dashboards provide real-time visibility into KPIs.
Customized Billing Approach
Medwave eschews the “one-size-fits-all” approach, instead customizing our solutions to fit each client’s unique needs across specialties, settings, EHRs, and workflows. We assess current processes to identify improvement opportunities. Meticulous business rules configuration enables claims to be generated accurately according to each client’s requirements. Our experts then handle all aspects of the billing process on the back end via well-honed protocols. Ongoing performance analyses help identify issues early.
Faster Reimbursement Turnaround
By leveraging electronic claims submission, automated workflows, and proactive follow up, Medwave expedites reimbursement turnaround time compared to in-house efforts. Clean claims and efficient correction reduce rejection rates that slow cash flow. Experts preview claims pre-submission to fix errors proactively. They also have direct contact with payer representatives to escalate delayed payments for faster resolution. Reporting provides visibility into unpaid claims by payer and reason for easy follow up.
Denial and Appeal Wizards
One key advantage is Medwave’s team of denial and appeal specialists. They manage the entire appeals process upon claim rejection as an extension of your practice. Our billers have deep knowledge of payer-specific reasons for denials and required documentation to overcome them. Every denial is evaluated for appeal opportunity. Communications with payers are professional and persistent to achieve an optimal overturn rate.
State-of-the-Art Revenue Cycle Technology
Medwave optimizes billing via integrated systems and automation
- Predictive analytics to anticipate potential claim trouble spots
- “Robotic” process automation for high volume repetitive tasks
- Real-time metrics dashboards with drill-down visibility
- Rules-driven workflows to error-proof processes
- Intelligent workflows to route tasks and escalations
- Custom reporting with scheduling and distribution
- Appointment scheduling-integrated eligibility checks
- Patient balance estimations and collections tools
- Automated claim status monitoring and follow up
This technology amplifies staff productivity while reducing manual effort and redundancy.
Detailed Reporting and Analytics
To enhance financial performance, Medwave provides comprehensive reporting on the most impactful medical billing metrics and KPIs. This includes denial rates, first-pass resolution, days in A/R, clean claim percentages, collection rates and more. Data integrations coalesce practice management, EHR, and other system information to uncover optimization opportunities. Our team reviews reports with clients routinely to discuss trends, deviations, and action plans.
Robotic Process Automation
Automation is also being applied to completing new patient registration paperwork, filing claims with attachments, following up on rejected claims, sending dunning messages and statements, verifying patient benefits during appointments, and auditing EOBs to ensure accurate payment posting. The benefits of applying RPA to these and other routine billing functions include reduced administrative costs, improved accuracy, accelerated processes, and allowing billing teams to focus on more value-add interactions.
According to Becker’s Health IT, over 70% of hospital finance leaders plan to invest in RPA, demonstrating the value automation brings to the revenue cycle. While no technology can entirely replace human oversight and judgement, purposefully leveraging RPA enables medical billing teams to operate at our highest capacity.
Enhanced Patient Collections
Given today’s higher deductibles and responsibility amounts owed by patients, collections are now a bigger revenue component. Medwave employs best practices to boost patient payments.
- Estimated collection amounts included in appointment reminders
- Patient balance portals with credit card processing
- Automated payment plan management
- Interactive voice response (IVR) reminders and automated collections
- Extended staff availability (evenings and weekends)
- Chatbots to answer common patient questions
This improves point-of-service payments while reducing billing team workload.
Increased Coding Reimbursement
Medwave’s certified professional coders are meticulous in capturing the full breadth of services provided as documented in the medical record. This avoids leaving money on the table. They are experts at identifying opportunities for improved code selection and sequencing. Vendors manage audits and provide ongoing coder education. All of this works together to maximize legitimately earned reimbursement.
Reduced Costs and Hassles
Outsourcing billing to Medwave provides additional overhead savings compared to managing in-house.
- No need to train, manage and pay specialized billing staff
- No software licensing fees and IT infrastructure costs
- Avoid claim denial write-offs reducing revenue
- Prevent billing compliance missteps leading to fines
- Increased collections and revenue covers easily outsourcing costs
- No weekend or night coverage needed from internal teams
This converts the billing function into an affordable fixed expense versus major resource drain.
Increased Focus on Patients
Perhaps most beneficial is freeing up your providers, nurses, administrators and staff from billing details so they can dedicate more time to delivering exceptional patient care. Research shows outsourcing administrative tasks like billing increases patient satisfaction scores.
Some Final Advantages of Partnering with Medwave
- Simple, straightforward per-claim pricing – no surprises or overages
- Guaranteed denial rate reduction and increased clean claims
- U.S.-based services – no offshoring of billing data
- Access to patient engagement tools to improve collections
- HIPAA-compliant security protocols to protect data
- 24/7 access to billing dashboards and reports
- Scalability to easily adjust for practice growth
- Seamless transitions for acquired clinics or new providers
Summary
In summary, Medwave offers a billing solution customized for your workflow needs, backed by credentialed experts focused on providing a high-quality experience. Converting this business function into a turnkey service allows your staff to devote our energy into caring for more patients. Proven results stem from Medwave’s specialized teams, purpose-built technology, and steadfast commitment to superior medical billing and collections. Contact our experts today to discuss how outsourcing can benefit your practice now and into the future.
