Medical billers must constantly upgrade their skills and techniques to keep up with the developments and avoid losing money. Failure to stay current on medical billing errors, laws and regulations, results in approximately $125 billion in uncollected revenue each year. The Revenue Cycle is a complex network of linked processes that hospitals, medical offices, and healthcare organizations use to monitor and collect revenues for the services they provide to their patients. Inefficiency and negligence in the processes like prior authorization, insurance, eligibility verification, payment posting, rejection management, and report generation might result in revenue leakage and cost thousands of dollars.
Here are some initiatives your healthcare practice may take to improve its medical billing procedures and maximize revenue:
Create a Simple Collection Process
Providers require a collections mechanism to improve financial stability of their practice. Establishing a plan that explains procedures to all parties involved may considerably improve revenue cycles by ensuring that individuals are appropriately and totally informed of their responsibilities. Obtain as much information about patients as possible, such as their address, phone number, email address, workplace, etc. Demand a photo ID during the patient’s first appointment; this is critical if a bill needs to be forwarded to a collections agency later. Check in with patients frequently to confirm they have not changed their address or phone number. To minimize claim denials, collect the insurance card and confirm patient eligibility during each visit. Collect co-pays and balances based on deductibles in advance to minimize the paperwork and labour required to track it down at some point.
Manage Claims Properly
Insurance companies are strict about medical billing and coding processes, and approximately 80% of medical bills are rejected because of errors. Rejection, editing, and resubmission can take weeks, leaving providers waiting for months to get paid for their services.
Checking for claim errors helps in reducing the possibility of rejections and denials, but if they exist, resolve them as soon as possible. Keep contact with a payer representative; they can help clarify issues with the original claim and provide information on current claims as they are handled. These can help speed up the claim editing process and reduce the time required for appeals and resubmissions.
Payer Contract Enforcement
Underpayment is another major issue for any practice trying to enhance collections. According to MGMA industry estimates, (711) % of medical practices are underpaid by payers. There’s the issue of various payers paying varying amounts for the same quality of service. The practice will suffer a significant revenue loss if payer contracts are not monitored and enforced successfully. Monitoring each underpayment is a significant issue that may be avoided by rapidly arranging and updating your charge schedule under the various insurance companies. Fee-scheduling difficulties can be rectified simply by revising your schedule once a month. That allows your practice to identify areas where you are underpaid and can maximize revenue.
Look For Ways To Enhance
Healthcare industry is changing, and physician practices must grow to maximize efficiency and income. Practices can discover issue areas and apply innovative solutions by tracking performance and staying up to date on the latest healthcare standards.
Physician practices should take the following measures to ensure maximum efficiency:
- Money owing to a healthcare facility is a vital figure to measure the effectiveness of their collection strategy. Tracking this amount from quarter to quarter and comparing it to the previous year’s data are great strategies to determine how well a practice’s revenue cycle is going. Such an evaluation can also aid in determining the impact of any newly established policies.
- Creating clear procedures for handling patient accounts means that the data will be available to assist in the identification of possible difficulties. Implement methods for monitoring problematic behaviors such as late payments, frequently denied payments, or constant changes in contact information to better target such patients for extra reminders and prepare billing personnel to outsource collections.
Persistent Cash Flow is the key to business success, and physicians work hard to deliver the best treatment to their patients. We’re here to keep your practice financially strong. We have medical billing professionals whose primary responsibility is to guarantee that claims are filed correctly and refused claims are resubmitted appropriately. We offer comprehensive medical billing services to streamline billing and revenue cycle processes. We will transform your revenue cycle to maximize your collections so that you can solely focus on giving quality care to your patients.