The U.S. healthcare system has created a tough spot for providers and patients. Several providers have experienced the outcomes of constantly changing billing guidelines and regulations and different time-consuming processes that have been introduced. And the effects combine to a single result; revenue loss.
The annual uncollected revenue due to the failure to stay updated with the altered medical billing guidelines and codes sums up to billions of dollars. Moreover, patients are also finding it difficult to pay their medical bills. Furthermore, the errors in the billing process affect them and disturb their pocket greatly. The deductible and out-of-pocket costs have risen by over 50% in the past decade.
Increasing the effectiveness of the billing process is a necessity, not a choice. If medical practitioners could skip it, there wouldn’t be hundreds of medical billing companies helping our doctors to streamline their billing and coding processes.
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It is crucial to prioritize a billing process’s well-ordered and effortless functioning. Experts are skillfully working around the clock to offer efficient medical billing services to doctors for better and safe practice and allow patients to get the expected care and treatment.
Medical Billing Tips To Maximize Revenue
Doctors can double their revenue by preventing the problem before it happens. This will ensure timely payments and reimbursements and let them provide their patients with high-quality care. The following billing tips can help doctors maximize their revenue:
Create An Effective Collections Process
A provider must have a collections process to ensure the financial health of their practice. Informing the patients regularly and thoroughly can ensure improvement in the revenue cycle. It is more beneficial to create a step-by-step approach for the collection process, which includes the following stages:
- Formation of clear terms
- Collection of patient information and demographics
- Address verification
- Getting consent for dropping billing messages
- Sending reminders to patients about their co-pays
- Constant eligibility and benefits verification
- Practice Up front collection
- Offering payment options immediately
- Sending letters to the patients when the payment time approaches as they carry more psychological weight than voicemail messages
It may be time-consuming to begin this process; however, providers can achieve a higher reimbursement collection rate once it is implemented.
Proper Management Of Claims
Insurance companies are very strict about medical billing and coding practices. Thus, any errors in medical bills can lead to rejection. Submitting, denying, rectifying, and resubmitting a claim can take weeks. This results in the provider waiting months to receive the payment for the performed services.
Accurate filing of claims and claim scrubbing can save much time and effort spent resubmitting a claim. It also ensures the approval of a claim the first time.
The most common errors to look after are:
- Incorrect patient details
- Wrong provider information
- Incorrect insurance information
- Duplication in bills
- Poor documentation of the services performed
- No Explanation Of Benefits (EOB) on a denied claim
Double-checking the claims before submission can minimize several billing problems. Regularly follow up on the claims till they get paid.
Avoid Coding Errors
Insurance companies decode a claim for payment through the codes entered by the medical coder for the services performed. Though this standard method can ease the process, any errors in the ICD-10-CM, CPT, and HCPCS Level II codes can be problematic. Often the clearinghouses detect common errors related to mismatched, incorrect, or missing codes. Nevertheless, it is difficult to spot some errors, which include:
- Non-specific diagnosis (ICD-10) codes
- Wrong usage of modifiers
- Under-coding
- Up-coding
Reviewing the used codes before submitting the claim can save you the hassle of resubmitting claims and piling up pending payments.
Handle Claim Rejections And Denials Beforehand
Claim rejections may be avoided by accurately entering the information. Still, claim denial requires the claims to be handled by an expert familiar with the billing guidelines and the insurance company’s rules. A claim denial takes a longer time to be fixed. Thus, reviewing the claims before submission should be of utmost importance.
Staying in touch with the payer’s representative can help expedite the claim editing process. Doing so minimizes the appeal and resubmission time.
Outsource When Needed
Medical practice is obliged to be mindful of their patients and the latest healthcare updates and staff management. Doctors should be knowledgeable and updated about the codes, billing regulations, and insurance companies’ rules. Missing any component can cost the practice money and time. And it isn’t very easy to gain knowledge of everything.
When the effort is maximum, and the outcome is not up to the mark, you can always opt for outsourced medical billing services. Another option that can be beneficial is of hiring a virtual medical assistant. Sharing the responsibilities with an expert virtual assistant can give you peace of mind and an increased cash flow.
Conclusion
The revenue cycle has the capability of making or breaking a medical practice. It is essential to focus on ways to keep the practice running and improve revenue. Following the above medical billing tips can help you understand the significance of timely-done tasks and will take the success of your practice to another level. Streamlining your practice’s billing process and cash flow is always possible.
