MEDICAL BILLING NETWORKS AND PROCESSES

A thorough, easy-to-reference guide to improving medical billing procedures and collections that will be of value to medical practices small and large.

Mathematician, inventor and CEO Lirov brings his broad range of knowledge and experience to the subject of medical billing. The company that he heads, Vericle, brings this technology to clients, but the book avoids frequent references to the enterprise and is clearly not an advertisement. Targeted toward those who are involved at any level with medical billing–including computer programmers, medical office or billing service workers, and physicians–the book addresses the problems that practices of all sizes face: how to simplify the payment process and maximize collections from clients and insurance companies. Lirov begins with an overview of the economics of health care today, comparing billing procedures and outcomes of the past with the strategies Vericle utilizes. He then explores the administrative aspects of medical offices, such as choosing the ideal billing system, computer-aided scheduling and problem tracking. The author also addresses metrics that are useful in determining efficacy of the chosen billing system–and what an office can learn from this study. Compliance with regulations including insurance claims and HIPAA is a large task for medical offices, and Lirov invited guest authors to detail their specific procedures. These authors contributed several chapters, covering topics such as physician “Super Groups,” dictation versus electronic records and integration of electronic health records. Other topics of interest include outsourcing of billing and patient retention. This well-written guide contains easily referenced chapters, section headings and lists of key points, with each chapter concisely summarized and indexed. Consequently, all office workers will be able to understand the language and terminology. Further, charts and diagrams provide examples and illustrate key points.

An excellent manual for medical offices seeking to improve billing.