Top 4 Strategies to Boost the Efficiency of Medical Billing Services

The frequent changes in the healthcare industry have made the financial management of a medical practice extremely complicated. Therefore, medical practitioners need to adopt innovative solutions that can help them to streamline the medical billing services.

No one can deny the fact that healthcare providers cannot achieve their financial goals until they get paid for the healthcare services, rendered.  Although the emergence of EMR and advanced practice management software has made the billing process easy for healthcare facilities, the rate of claim denials is still touching an alarming level.

It is estimated that approximately 30% of potential revenue remains uncollected due to the inefficiencies in the medical billing process.  No doubt, claim denials have become a common phenomenon in revenue cycle management. But if this rate exceeds the specified limits you may have to face a critical financial crisis in terms of revenue leakage and cash flow disruption.

Therefore, it is important to pay special attention to the optimization of medical billing and coding services. The entire process of medical billing is time-consuming but very crucial for healthcare facilities.  That involves a series of interactions between the medical practitioner and the insurance company, with the aim of collecting payments for the healthcare services rendered.

If your billing process is on the right track, then you will stay financially fit. It is only possible if you have a dedicated team that works hard to shorten the billing cycle, collect payments quickly, and increase the number of collections. Without the help of industry experts, you cannot increase the productivity and profitability of your medical practice.

However, if you are struggling with the high rate of claim denials, then you should adopt the following strategies to boost the efficiency of medical billing services.

Accurate Patients’ Information

The front desk staff plays a crucial role in the entire healthcare revenue cycle management. Because they are responsible to collect the patients’ demographic information such as: name, date of birth, phone number, gender, age, address, insurance ID, policy number, and other basic information.

Medical billers use this information while preparing claims. A slight error in this information can lead to claim denials. Moreover, It’s also the responsibility of the front desk staff to verify the insurance eligibility of the patients.

So, in order to prevent such errors, registration staff should direct patients to bring copies of insurance cards, IDs, at every visit. By doing so, you will process the medical claims with the correct insurance information, and the chances of claim denials decrease.

Moreover, the registration staff should collect copayments at the point of service as well as any balances due.  The best solution to minimize the errors is the implementation of electronic solutions e.g. electronic healthcare records and practice management software.

Therefore, it’s important to make sure that your registration staff has access to the latest software. That helps to keep the patients’ information secure and error-free. Moreover, medical billers can easily access this information whenever they need it.

Avoid Coding Errors

Medical codes play the role of invisible engines in medical billing services. Coding is the process of describing patients’ diagnoses, treatments, medical equipment, and procedures by using standardized codes. Usually, medical coders use ICD-10-CM, CPT, and HCPCS Level II classification systems.

Insurance companies don’t accept claims that contain coding errors such as incorrect, mismatched, or missing codes. However, there are some complicated errors that can land you in legal trouble such as: heavy fines, federal penalties, and even imprisonments.

Upcoding, under-coding, unbundling, and incorrect modifiers are the main reasons behind such troubles.  Upcoding is considered fraudulent billing that occurs when medical coders assign a code for a more expensive service or procedure than the one that was performed.

So, in order to avoid such errors, coders should double-check the provided information and claims before submitting the medical claims.

Submission of Clean Claims

Clean medical claims are an integral part of the medical billing services and the reimbursements are highly dependent on the timely submission of medical claims.

There are some healthcare providers that are still using the orthodox methods of data collection, processing, and even manual submission of claims. Such methods always leave a huge room for mistakes.

Therefore, medical practitioners should stop using traditional methods and prefer to submit the claims electronically.  The advanced billing software tools, not only reduce the burden of billers but also ensure accuracy in the entire billing process.

Less human interference reduces the chances of errors, which ultimately reduces the chances of claim denials. As a result, healthcare providers enjoy a streamlined cash flow.

As the healthcare industry is witnessing constant changes in terms of state laws, insurance policies, medical billing, and coding, it is crucial for healthcare providers to stay at the top of these changes.  They must undergo constant training to keep pace with the ever-evolving healthcare industry.

Outsource Medical Billing Services

In this challenging era, healthcare providers are working as front-line heroes to fight against this deadly pandemic. They don’t have sufficient time to handle the revenue cycle management efficiently.  Therefore, they prefer to outsource their billing and coding services to a trusted medical billing company.

Outsourced medical billing experts have extensive industry experience and in-depth knowledge about the current industry standards. On the basis of their knowledge, they ensure the timely submission of error-free medical claims.

They track a medical claim throughout its journey until healthcare providers get reimbursed.  Moreover, they reduce the administrative burden of the healthcare providers and allow them to spend a considerable amount of time providing quality care to the patients.

In addition to this, by hiring a reliable medical billing company, healthcare providers can save a hefty amount on operational costs such as: deployment of billing staff, training, employees’ incentives, paid holidays, office workspace, purchase, and maintenance of advanced billing software. This decreases the financial burden of medical practitioners and they enjoy a health bottom-line in a fixed amount.

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