Recent changes in the healthcare system have brought a lot of new challenges for practitioners in the United States. Many aspects of healthcare reform have changed with the passage of time i.e. value-based compensation models, frequent alterations of the rule engine for billing services and other federal policies. Due to these ongoing modifications, physicians have to stay well-versed with the updates. Hence, they also need continuous training in medical and coding rules. Staying outdated is a black spot for medical practitioners as they can’t let down the quality of their clinical services due to revenue loss.
Therefore, in order to avoid this hassle, medical practitioners should adopt the right strategies to stay compliant with the health billing trends and improve the quality of care services parallelly. In this article, I have mentioned 6 proven tips to optimize medical billing services that would help you drive maximum revenue and leverage your business growth index.
1. Develop A Well-Defined Medical Billing Process
All medical practitioners should organize their administrative and financial responsibilities in the form of a well-defined plan. It is the best approach to establish a step-by-step procedure that clarifies all the procedures involved. In this way, practitioners can track down the progress of the overall billing procedure and make improvements at every key step. It can greatly enhance revenue cycle management by ensuring the authenticity of every attribute involved in health billing. It will also help to ensure that your patients and payers are receiving clearly correct bills. Ultimately, it would improve patient satisfaction and provider-payer relationships.
2. Claim Management Process:
A recent survey conducted has revealed that almost 80% of all medical bills contain errors. Due to the strict insurance payer’s policies, these incorrect medical claims end up in denial and rejection. Although billers can resubmit these claims to appeal outstanding payment. However, the cycle of claim submission, rejection and resubmission consumes a huge amount of time.
In order to prevent the precious amount of time for providers, billers should establish a proper claim management process. They should dedicate well-experienced resources and equipment that can monitor all of the paid and unpaid claims. Use smart billing software solutions to file accurate claims in the first attempt. They should also ensure accurate information flow throughout the claim submission process. For this purpose, they should double-check the claims to identify any possible information error before submitting claims. So that payers and patients can receive clean claims that can be successfully reimbursed afterward.
3. Minimize Medical Coding Errors
Medical codes are the framework of health billing services. The purpose of a bill is to define treatment and diagnostic procedures into standard medical coding protocols. These medical codes are classified as ICD-10-CM, CPT and HCPCS Level II classification systems for different medical procedures, respectively.
Although it is a standard method to describe procedures, errors can occur in this aspect as well. It includes the most common errors such as incorrect, mismatched, or missing codes etc. Clearinghouses and payers can catch these errors easily. However, some of the medical coding errors are quite complex and also end up in negative results. For instance, if medical coders use less detailed ICD-9 codes instead of highly specified ICD-10 codes then such a claim would end up as denied or rejected. If medical coders have used incorrect modifiers, upcoding or under coding, such errors can also make your claims get wasted down the tunnel due to rejection or denial.
4. Implement Proper Denial Management System
Medical billers should have a proper plan for denial management services in place. This plan is helpful to keep pace with outstanding claims. Oftentimes, when billers don’t follow up with unpaid claims then they fail to identify common mistakes or errors that cause claim denials and rejections.
Therefore, if medical billers would dedicatedly follow up with their denial management services then they would get insights about the most common errors. Checking for errors in the claims would help to minimize their occurrence in further claims. In this way, it could streamline health billing services at a constant pace. It would also enable billers to track down unpaid claims and recover them in a timely manner. Hence, reduces the chance of frequently occurring errors, claim denials and revenue loss.
5. Streamline Revenue Cycle Management
To keep pace with the rapidly evolving healthcare field, billers should also follow a dynamic suite of revenue cycle management services. By tracking performance and complying with the latest regulations and payer’s policies for health billing services, practitioners can identify problematic areas and implement new strategies to address these issues.
In order to ensure greater profitability and efficiency of your revenue cycle management, providers should adopt the following strategies;
- Keep the track record of aging account receivables to capture the outstanding owed to your healthcare facility.
- Stay on top of all the billing rules that keep changing, deleting or updating with the passage of time.
- Adopt a well-managed healthl billing solution that can handle patient accounts and keep you abreast of all the potential challenges.
- Use key identifiers to track problematic issues i.e. late payments, regularly declined payments or frequent changes in contact information to get better results.
6. Know How-To Outsource
- Know How-To Outsource:
Practitioners should constantly strive to uplift the quality of their clinical care services. Maximum patient satisfaction adds more value to the business growth. However, if practitioners tend to keep their medical billing services within their office premises then they would have to strive hard to stay current with most recent medical billing and coding rules, insurance companies and federal regulations. With so much to keep up with, practitioners can skip administrative details through the cracks, resulting in claim denials and rejections that cost the business’ time and money.
If you are experiencing a number of obstacles in collection management then you need to consult with expert medical billing service providers. Despite their industry knowledge and experience, they have dedicated resources to look after your account receivables. With their proactive health billing services, they contribute a lot to nurture the financial health of your organization.
Although many healthcare practitioners find that even hiring a hralth billing company doesn’t make a difference. This is often due to the wrong choice, lack of industry research and outsourcing knowledge. In order to hire the best services for your business, medical practitioners should do thorough industry research, read the online reviews about a company, assess their industry experience and estimate the size of their workforce. If you find every factor favorable for your business then you should make a partnership with a medical billing company to keep your revenue cycle management in safer hands.
Otherwise, in response to increasing complications, multiplying billing and coding rules and constant labor and software maintenance costs for inhouse services would impact your practice negatively.
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