What is Medical Revenue Service – Overview
Medical Revenue Service (MRS) is crucial from the business aspects of a healthcare facility, such as hospitals and clinics. It is impossible to manage critical administrative tasks, such as charge capturing, billing, and revenue recycling management, with MRS professionals.
These services can be provided by an in-house MRS professional or by hiring a third-party vendor. Revenue services in the medical and healthcare industry are essential for the smooth day-to-day operations of a healthcare provider.
Revenue services in the medical industry can include different things, such as billing, collection, and marketing campaigns. These services also use proper medical coding practices to ensure prompt and accurate billing and payment.
In this article, we shall take a closer look at what medical revenue service is and its importance in the medical industry.
What is Medical Revenue Service (MRS)?
A medical revenue service provides revenue management to healthcare professionals, groups, hospitals and other healthcare systems. They are specially trained to handle the billing and collections aspect of medical practice so that healthcare professionals can focus on patient care.
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These services help doctors to collect money from insurance carriers or patients, besides ensuring that the revenue stream stays open and grows.
There are numerous companies today that offer excellent medical revenue services. Many healthcare professionals, hospitals, clinics, and other healthcare facilities hire these MRS vendors mainly to provide comprehensive medical billing services.
These services may also include assisting with essential administrative and organizational aspects of the client’s organization. Additionally, these companies also offer to perform claims processing, insurance verification, and even patient registration.
These MRS providers are essential for large hospitals and small medical facilities alike.
What Does Medical Revenue Services Include?
As mentioned earlier, there are loads of different kinds of services included under the Medical Revenue Service. Here are some of the major ways that MRS helps healthcare providers and facilities maintain a streamlined administration and smooth revenue cycle.
1 – Prevent revenue cycle leakage
Revenue cycle leakage occurs when the healthcare provider cannot determine which patients are behind in paying pending bills. This creates a problem as the patient may choose not to visit the doctor, and they may lose revenue.
To prevent this, an MRS professional can ensure accurate billing and coding, double-check to ensure the patient has provided correct information and details, and avoid revenue cycle leakage.
2 – Manage Medical Coding and Billing
Medical billing and medical coding are interrelated and help ease payment between patients, health insurance companies, and healthcare providers. Professional medical billers are responsible for processing patient payments and insurance claims with the insurance carrier.
Medical coding professionals work to review the patient’s diagnosis and ensure that the codes are in order so they can assign the correct billing code.
As medical professionals like doctors and surgeons are not trained in medical billing and coding, the MRS professional can handle that aspect of their healthcare facility.
3 – Ensure streamlined revenue generation
There are two types of medical billing done in a healthcare facility:
First, professional billing happens when a patient visits a healthcare provider at a hospital, clinic or other healthcare facilities. This also includes independent doctor’s offices. The payment process involves sending a bill to the insurance carrier who reimburses the healthcare provider.
Experts can perform medical billing and coding, the two major functions supporting a hospital or clinic’s revenue cycle. Professional billing is aimed at billing claims that are generated for services provided by healthcare professionals, suppliers, and even non-institutional providers, including inpatient and outpatient services.
On the other hand, institutional billing occurs in handling the bills for clinics, hospitals, rehab facilities, nursing homes, etc. This involves inpatient and outpatient services, along with the expense for the use of laboratory, equipment and ancillary services.
The main difference between professional billing and institutional billing is that institutional billing services manage the healthcare facility’s daily billings and payment collection process. They are not responsible for coding or documentation that is required to provide these services.
As hospital coding is more complex than coding required in clinics, these healthcare facilities hire medical coding and billing professionals who are specifically trained for either.
How Does Medical Revenue Service Work?
The medical revenue service starts after the doctor has examined the patient and decided on a medical remedy. The MRS professional then sends an invoice for the services to the patient’s insurance carrier, which decides if the claim should be reimbursed. Once the claim is processed and approved, the required payment is sent to the hospital or clinic.
Medical billing seems intriguing to many people as they believe it does not require much education or training. However, this is far from the truth, as medical coding and billing professionals undergo challenging training to get certified. This is especially tough for candidates without experience in the medical or healthcare industry.
Besides this, an MRS professional also offers other services, such as conducting financial clearance. This involves maintaining and verifying patient information before the patient’s arrival for the appointment. In addition, it is essential to maintain accurate and updated billing records to ensure that patients are billed correctly.
These services also help to streamline the admission and discharging process at hospitals and inpatient and outpatient facilities alike. The patient information process must be streamlined during check-in and check-out. This helps to avoid double-checking and redoing the entire paperwork later on.
Essential medical documents are necessary for successful financial clearance. In addition, it ensures that regulatory practices are being followed so insurance carriers can reimburse for services more promptly.
Lastly, an MRS professional also ensures that an effective electronic charge capture process is used. This includes recording the patient’s information, such as treatment type and billing data, before the arrival of the patient at an appointment.
Medical revenue services are essential to ensure the smooth running of the administrative aspects of any healthcare provider. MRS professionals are trained in medical billing and medical coding of all types and can handle professional billing and institutional billing effectively.
An MRS provider helps ensure that the healthcare provider can focus on the health service aspects without worrying about proper billing and coding for prompt payments.
I am a dedicated healthcare researcher and an enthusiast specializing in medical grants, medical education and research. Through my articles, I aim to empower healthcare professionals and researchers with valuable insights and resources to navigate these critical aspects effectively.