Because the healthcare industry is always changing, so must the billers and coders who work in it. All of these staff members must be up to date on the most recent billing and coding practices. Your medical facility will be able to keep as much money as possible this way. Many people believe that with the addition of new billing technology and tools to EHRs, medical billing and coding will never be the same again. This type of technology helps facilities avoid billing and coding errors while also ensuring that everything is submitted on time.
Get Your Coding Done Correctly
One of the most important steps in increasing collections is proper medical coding. You must code correctly to meet industry standards, and you must also reduce the number of rejections you receive. This way, you can get as much money as possible for the services you’ve provided. Every claim has a fee that must be paid before it can be resubmitted, so each claim that isn’t filled out correctly costs your facility money. If you want to collect as many claims as possible, it is best to get them right the first time.
Clean Claims Should Be Submitted
Naturally, the more claims that are denied, the more money you will have to spend on claim resubmission. As a result, make certain that all claims submitted are completely clean. Clean claims result in faster reimbursement, which can help you optimize your collections. Many facilities have first-pass acceptance rates of around 80%, but this is not where you want to be. If claims are submitted correctly, medical facilities should have a 97 percent acceptance rate. If you are not meeting this percentage, investigate the reasons for claim rejections and determine whether you have the appropriate technology to meet the needs of your practice.
Contract Enforcement by Payer
Underpayment caused by payers can be a problem for medical practices that want to maximize their collections. If you do not manage and enforce your payer contracts properly, you will lose a lot of money. Because keeping track of all your contracts can be difficult, having the right technology can be extremely beneficial. The right technology will be able to identify underpayments and assist you in disputing them with your payers so that you can receive the reimbursement you were hoping for.
Choosing Between In-House and Outsourced Medical Billing
Many practice managers and doctors are faced with the decision of whether to do their medical billing in-house or outsource to another company on a regular basis. The correct answer will differ between practices and will be determined in part by a number of factors such as the age of your business, the practice’s financial situation, and the size of their local labor market.
Aside from clinical services, revenue cycle management and billing will be the most important processes in your practice. This means that deciding whether to outsource or do billing in-house is a significant decision. We will compare in-house and outsourced medical billing to see which is best for your practice.
Medical Billing in-house
You have more control over your financial operations when you do your medical billing in-house. This added control can make a practice feel safer. While you will have to train your own employees, which will incur costs, you will see long-term returns on your investment. It is a waste of time and money to train staff only to outsource medical billing services later. Once your staff is trained, you are more likely to keep training staff in-house and refining processes as needed. It’s also more convenient to have your medical billing done in-house because if any issues arise, you can simply walk down the hall to your billing department to have them resolved.
Medical Billing Outsourcing
There are benefits to outsourcing your medical billing services. It is less expensive to outsource because you do not have to invest in training new employees or pay their salaries and benefits. You also do not have to micromanage any of your employees. When you require comprehensive performance reports, they should be able to provide them.
One of the drawbacks of outsource medical billing is that it is a more hands-off option. This is fine for some people, but for those who want more control over the process, giving up control to another company can be difficult. It’s also more difficult to predict how much money you’ll spend because most medical billing companies charge a percentage of the collections. This means that the money you pay them is proportional to what you bring in, making budgeting your expenses more difficult. There may also be hidden costs, such as startup costs or reporting fees. You don’t want the money you save to be offset because of the expenses you didn’t notice.
- Recent changes in how we deliver healthcare in the United States have created revenue collection challenges.
- Your company must decide whether to continue handling billing in-house or to outsource it to third-party professionals.
- A clear, documented view of how you collect payments is a great way to improve patient collections.
- Always make an effort to collect payment at the time of service. You can train your employees to use the best phrasing to ensure a positive response from patients.
- When you first sign patients up for your practice, collect as much information as possible from them, including contact information in case you need to send bills or notifications.
- Using the right software and technology tools can help you avoid annoying patients and missing payments.
- Use training materials and provide incentives to your employees to help them manage payments better.
With so much work and attention to detail required for successful medical billing and ensuring proper payment from each patient you treat, chances are you’ve thought about outsourcing this critical task. Patient engagement plays crucial role to overcome payment issues and other relevant things.
This is especially true as your practice grows and you have many more patients to collect from than when you first opened your doors. Many practices decide that outsourcing medical billing to a reputable company is the best way to focus on providing health care rather than getting reimbursed.
Medical Billing Mistakes
Medical billing is a complex process that necessitates a great deal of care and attention. Because there is so much that goes into it, problems have been reported when organizations attempt to file claims. Here are some of the most common medical billing mistakes, as well as some preventative measures.
Nobody wants to be charged twice for the same treatment. Unfortunately, this is not uncommon in the medical field and is a surefire way to irritate a patient. This error has been observed when a provider fails to check to see if the patient has already paid for the services received. As a result, patient bills must always be monitored, and there must be clear communication among staff members.
People are bound to make errors. A staff member or medical billing specialist who processes several claims per day may overlook critical information or accidentally enter the incorrect code. It is critical that every piece of information on a claim be correctly filed in order for it to be processed. To reduce the possibility of errors, go over key pieces pertaining to a patient’s account. Name, contact information, billing address, and so on. You must also ensure that you enter the correct insurance information, such as your address and policy number.