Efficient medical billing and collection management are indispensable to any successful healthcare provider. It ensures your practice remains financially viable and can support the high cost of providing healthcare. But making sure your practice is paid for its services isn't always straightforward.
It can be difficult since many healthcare providers are reimbursed by third-party payers (e.g., insurance companies and health maintenance organizations) after the patient has received the service. This scenario leads to delays between providing services and collecting payment. Furthermore, insurance claims could be subjected to rejection or denial.
Under these circ*mstances, what can you do to reduce your losses and guarantee prompt and complete reimbursem*nt for your service? This article presents a list of top actionable medical billing tips that can help you efficiently manage your billing processes.
Top 10 Best Medical Billing Tips
It is possible to increase on-time payments by improving medical billing practices internally. These medical billing tips will help your practice stay on top of your medical revenue flow:
Learn the Ins and Outs of the Billing Process
The first step towards improving your billing process is to understand how medical billing works fully. A medical billing system has six main steps.
- Checking insurance eligibility – Verify an individual's insurance coverage and whether the facility accepts it.
- Collecting the patient's portion– Patients are usually responsible for paying a part of the bill (copayments, coinsurance, deductibles) and insurance companies cover the rest. Make sure the patient is aware of their financial responsibility.
- Sharing procedure and diagnosis codes -Generally, a medical coder is a bridge between the provider and the insurer. There is a specific code attached for each procedure, diagnosis, and treatment performed by a provider. The insurer receives this code so they can reimburse you. First, the provider shares it with the coder.
- Checking the correct code selection-First, the coder receives it from the provider. Then, they check this data to make sure that the codes are valid. For medical billing coding to be accurate, the coder must know the specifics of procedure coding and add the relevant modifiers.
- Submission of medical claims-After coding all the patient's procedures and treatments, you can submit a medical claim to their insurance company.
- Receiving reimbursem*nt-When the patient's insurance company receives your claim, they determine whether to approve it or deny it. After approval, you will get reimbursem*nt, along with any remaining balances. If they deny your claim or only partially reimburse you, you must resolve this issue immediately to avoid cash flow problems.
- Tracking and inventory: Keeping track of denial statistics and the reasons for the denial and recurring denials can help detect and prevent future denials.
Establish a Clear Medical Bill Collection Process
Set up a clear and systematic collection strategy. The best way to achieve this is by creating a step-by-step collection and billing process flow chart. Each stakeholder must receive clear instructions. This includes your patients. When your patients understand their responsibilities, it makes a big difference in your medical revenue cycle.
Patients should know what their co-pays are and have these co-pays collected beforehand. The patient should receive a letter if their bills are due, are overdue, or if their accounts are due for collections. As a final step, you should make sure that it is clear what payment options are available and what forms of payment they can use.
Additionally, having the information readily available on your website, forms, and frequently asked questions section will eliminate any confusion.
Train Staff
Your staff should understand their responsibilities and every step in the billing process. When you have well-trained staff at your clinic, you have the assurance that insurance policies undergo verification correctly, calculate copayments accurately, and send insurance claims to insurers with correct codes. Providing your new hires with thorough training about the collection process is also essential.
Keep Medical Billing Coding Errors to a Minimum.
Medical billing revolves around the use of the correct codes. When submitting a medical claim, you should double-check the code to make sure it's accurate. Look for common coding blunders such as nonspecific code usage or incorrect modifiers.
Another common error is upcoding, where a patient has been charged more for a higher value procedure or under coding, in which they indicate a procedure with a lower value. A code error may even be a decimal point-off. To avoid this issue, medical practices need to have professional coding staff who have a comprehensive understanding of medical billing coding guidelines.
Gather Accurate and Thorough Patient Information
Having accurate information is essential when billing an insurance provider or collecting payment from a patient. By gathering all necessary patient information upfront, you will avoid many mistakes later on. The accuracy of billing depends greatly upon hiring front desk staff that is organized, systematic, and meticulous. Data about patients includes their name, date of birth, phone number, gender, age, address, insurance ID number, policy number, etc.
Offer Patients Easy Payment Options
Make sure your patients receive clear and readable statements that help them keep track of when their payments are due. It can be challenging to collect payment if the billed amount is not collected at the time of service, which typically means multiple phone calls and emails.
By accepting various payment methods, such as cash, checks, credit, and debit cards, you increase your chances of collecting the balance at check-in. You can also make payments more accessible by integrating an e-payment option into your patient portal.
Integrating technology into your processes is one way to help your front desk become more efficient. Replace traditional forms with tablets which patients can easily use to fill out their requirements. Technology enables you to avoid errors due to poor penmanship or lost documents.
Filing on Time
In general, there is a deadline for filing a claim with a payer. It is not uncommon for an office to have denials if they take too long to submit them. Whether the billing department submits a claim before the deadline, the payer might not accept it immediately. You can submit a secondary claim after the secondary payer's deadline, but it will result in lost or delayed revenue.
Follow-up on Inquiries Diligently.
The billing department must maintain constant communication with insurance companies and patients. Even though you have sent letters and emails, follow-up remains crucial to track all inquiries and concerns. You may be denied a claim or have your income delayed if you fail to follow up.
Be Updated
Keeping abreast of the current laws, coding edits, state and federal regulations, and insurance contracts permit you to effectively voice your concern for patients and your practice when confronted with denials. You can usually sign up to get monthly updates from insurers on their websites. In addition, you can register on the websites of state and federal carriers to receive informational bulletins and newsletters regularly.
Outsource Your Medical Billing
Your practice can significantly benefit from outsourcing the services of medical billing companies. As experts in medical billing, they know the process inside and out. During the medical billing process, they can navigate and prevent numerous complications that may occur.
Professional billing staff is also adept at submitting claims using the correct medical codes. They can make billing quick, easy, efficient, and accurate. As they will spend all of their time and energy on billing, you will be able to focus on providing quality care to your patients.
Partner with DrCatalyst
We at DrCatatyst understand that your billed services and accounts receivable are some of your most important financial assets. DrCatalyst will take care of all your billing needs, whether you are looking for full-service RCM, hourly billing, or help with a particular step. Our team of highly trained, hands-on, organized, HIPAA-compliant AAPC-certified service providers will fit the scale and specialty of your practice.
Book an appointment with DrCatatyst today!
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