The medical billing process’ authority and behind-the-scenes machinations make the revenue cycle far more complicated than it was before software automation tools were introduced.
When patients present with a complex case or a significant medical history to consider, the medical billing services take not just days, but months to complete.
Even for the most routine of care, the situation necessitates ongoing review due to the challenges that come with coordinating internal practice workflow with all of the demands imposed by claims processing vendors and external clearinghouses.
You should be aware that your organization has a variety of options for improving the coding and billing process, resulting in faster submission times and higher first-pass approval rates.
Here are eight ways to improve your organization’s medical claim billing process right now.
1. Make the collection process clear upfront
For more efficient medical claims billing efforts, open and transparent communication with patients is critical. Make sure you tell new patients that they are responsible for paying for the services they receive. You can include the information in the paperwork that patients complete before their first appointment.
Patients will not be able to claim they were unaware of your policy if you post a sign in the reception area explaining the payment system. Obtain billing information from patients on the same day to support timely collections, including a copy of their insurance card and a photo ID for your files.
2. Update and maintain patient records
How can you expect to accurately handle claims billing if you don’t have precise information on all of your patients? At each visit, you’ll want to remind staff to double-check patient demographics and insurance information. What justifies this? For example, your patient may have changed jobs and switched insurance providers, or a new spouse may be providing coverage.
The nature of insurance may have changed as well, with a patient upgrading to the most expensive plan with the lowest deductibles, or downgrading to a less expensive plan with much higher out-of-pocket costs. Make it a point to explain the process as you update your patients’ information so they aren’t surprised by a higher bill. Double-check the policy number and subscriber information, for example (including the medical billing services for the health insurance company). This information must match the records of third-party payers.
3. Automate the basics of billing
Forcing employees to perform tasks that could be done more efficiently by automated systems is inefficient. It lowers employee morale and frustrates workers who could otherwise focus on providing more patient-centric, personalized service. Find routine and mind-numbingly repetitive billing tasks. Individual claims must be filed, payment reminders must be generated and sent out, and assistance in selecting the appropriate medical billing services codes must be provided.
4. Prepare yourself for success.
Every insurance company with which your company does business will have its own set of rules. An insurance company may require you to submit chart notes with new patient claims in order to establish a primary care mecidiyekoy escort relationship. Insurers, on the other hand, may request chart notes only to support follow-up care or non-standard treatment protocols.
Update and expand your employee training programs to include components that help to bill departments quickly locate pertinent filing requirements and patient files. This ensures that each carrier has the information they need to process claims quickly after you submit them.
5. Monitor Denials
Having a system of checks and balances in place will improve first-pass rates whether a practice uses an external billing and coding vendor or processes claims internally.
Rather than chastising employees for errors, adopt the mindset that every rejection is an opportunity to improve the process. When denial rates are higher than expected, for example, it could indicate that your team needs advanced training or that your scrubbing process is inadequate for your current workflow.
The following are common reasons for denials:
Physicians lack the necessary credentials.
You don’t have enough supporting documentation.
When you track denial codes, you might notice some simple ways to improve your practice’s efficiency. Sending daily chart notes and billing codes to the billing department, for example, could save time and improve accuracy.
6. Outsource the most difficult collections
You and your fellow stakeholders may be hesitant to consider outsourcing work as a provider who has been serving the community for many years. But, especially when the efficiency of your revenue cycle is at stake, it’s prudent to keep an open mind. Working with a third-party healthcare rcm services company frees up your employees while experts handle the more difficult collections.
They will treat your patients with compassion and sensitivity while assisting them with their outstanding bills, such as setting up a payment plan. Your staff will no longer bear the brunt of disgruntled patients who can’t pay their bills, and your cash flow should improve.
7. Improve Quality Assurance
To be sure, eliminating claim errors is critical for your practice’s financial health. The billing and collection process, on the other hand, does not end once a claim is approved. Medical providers can keep a close eye on their cash flow by using generally accepted accounting practices to post and record payments.
Create a deposit log for each receipt and send it to the billing team to improve account balance accuracy. The log should contain all necessary information to ensure proper posting and make it simple for a reviewer to confirm the correct payment amounts posted to the appropriate accounts.
These basic details should be included in a log:
- The patient’s name
- Number of accounts
- The number on the check/cash receipt
8. Follow-up on unpaid claims
You may notice communication issues with insurance carriers or patients after thoroughly reviewing old accounts receivable.
Are your statements simple to comprehend for patients? Are the billing and medical coding company processing your claims quickly?
Implementing processes and patterns that assist your team in filing claims faster and more efficiently for revenue capture is critical.
Finally, reviewing the medical billing services from the initial patient contact to check deposit will allow you to improve the claims process and capture reimbursements more efficiently, resulting in increased cash flow.
