Legion Healthcare Solutions

Hospital Billing Services

Hospital Billing Services

Each and every hospital has one mission to serve every American citizen, however, the fragmented healthcare system is leaving millions of people without the required healthcare facility. The biggest burden that any hospital face today is to deal with more 1,500 insurance companies each having different plans and often a unique requirement for hospital bills. At Legion Healthcare Solutions (LHS) we understand the bustle of the modern healthcare system and regulations that run into thousands of pages.

Hospital billing drives into the whirlwind of complicated medical billing guidelines, for example: Medicare patients currently account for 41 percent of hospital volume of patients for which U.S. congress sets hospital payment rates, and for Medicaid, state governments set the hospital payment that accounts for 24 percent of patient volume. At LHS hospital billing we understand the need of maintaining the reimbursement from each claim and deploying a billing manager for each claim for Orthopedic Medical Billing Services is the first step.

“Hospital Billing requires us to be at the peak of our efficiency, most patients coming are usually out-patients and their underlying medical condition is usually missing. We begin with documenting what we have and then move the insurance side predicting the payment amount. With Medicare and Medicaid, the payments are usually brought down, making us reapply.”

– Billing Manager for hospital billing at Legion Healthcare Solutions

Most private insurance companies providing hospital care packages negotiate huge discounts, making the insurance companies lose money even at this step. Uninsured patients make a part payment or no payment at all, making hospitals accept the complete cost of patient care unpaid.
According to a survey, 66 percent of the hospitals lost money in Medicare insurance and 26.4 percent lost money overall from Medicaid, private insurance, or uninsured.

Credentialing

With over 1,500 insurance companies, Legion focuses on a demographic region when it comes to credentials. We connect insurance companies with every physician in a region and when the hospital needs an expert they can be assured about the payment for the procedure. Legion even negotiate based on diagnosis and procedure costs for hospitals.

Documentation

Hospital billing depends on the procedure and diagnostic coding. Patient documentation will assist you to leverage the underlying patient condition and gain maximum reimbursement. In case of outpatient, hospitals are recommended to get patients' insurance details. LHS understands the importance of patient documentation and prior authorization, hence a team works 24/7 to fulfill all requirements of Hospital Billing Services.

Experienced billers and coders to support hospital billing 24/7 with documentation and prior authorization.

Credentialing for each physician coming into the hospital billing network.

Extensive audit before any claim submission to reduce claim denials. Legion achieved 98 percent claim approval for the first time.

To improve the low reimbursement rate for hospital billing, billing managers set a specified target for each claim depending on procedures.

Training sessions for coders and billers to keep them updated about new regulations and coding changes.

API-and RPM-based solution to improve patient care.

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