While your patients’ health is your top priority, your office requires a regular, stable source of revenue to provide the finest possible care and treatment.
As a result of inefficiencies in the billing process and claim rejections, medical practices today are losing up to 30% of their revenue. The great majority of suppliers strive for a successful revenue cycle management approach. Revenue cycle management directly impacts your income and that of your staff.
With all of this in mind, many healthcare professionals are left with the same question: how can patient service billing collections be maximized?
BellMedex, a Medical Billing company, is well-versed in today’s healthcare revenue. BellMedEX identifies the top medical billing recommendations to enhance your cash flow and revenue stream so you can give top-notch care to your patients.
1. Terminology Clarity
Before you do anything else, go over your present medical billing regulations and terms and make any necessary revisions to improve clarity. There are numerous actors to coordinate, including physicians, medical billing coders, insurance companies, patients, and other responsible parties. Each party must understand their role in payment responsibility, and your terms must be crystal plain to them.
Your practice’s chances of billing errors are reduced if your terms are crystal clear. Creating clear, consistent phrases will result in a more efficient medical billing procedure in the long run.
Clear terms are critical since one-third of insured Americans discover after obtaining care that their health plan does not cover as much of their medical expense as they anticipated.
The price hike suggests that patients don’t always understand how their treatment will be paid for. It is your responsibility as their supplier to make it clear.
How do you get patients to pay more?
There are a few ways to guarantee that you have clear terms to ensure that all parties are aware of their responsibilities and that payments are made in full and on time.
Increase Patient Payments with These Tips:
On appointment tasks
Ensure that new patients are adequately informed about their financial obligations during onboarding and subsequent visits. Patients should be notified when payments are due, both in the office and via outreach after their visit.
Before a patient leaves the appointment, make sure they understand their copay obligation. They should pay the copay before leaving, if possible.
Double-check the patient’s insurance eligibility during each appointment or use computerized insurance verification. This reduces the number of rejections.
Provide patients with information about the various payment options available at the service. A wide range of payment choices is beneficial in ensuring that most patients have access to some form of payment. Do you accept cheques, credit cards, debit cards, cash, or payment plans at your office? Please spread the word about these possibilities.
Give patients explicit instructions on how to pay back their debts. Ensure that new patients are properly onboarded and that they are seen regularly.
To help your patients understand what’s available, share these options.
Double-check patient information
Verifying your patient information is a simple but efficient technique to ensure you’re collecting the payments you’re entitled to. Healthcare providers lose money every year because of erroneous patient information. Many denials are caused by incorrect patient information. 90% of errors are avoidable. Avoid claim denials by taking this simple step.
Each time your patients come in, have them double-check the following information:
- A name (for accurate spelling or any changes due to things like marriage)
- Home address at the moment
- Cellular phone number
- Contact information via email
- Information on insurance
- It’s also good to have a photo ID with you on your first visit. In the terrible case that something goes wrong, this will come in handy. This will come in handy if a bill needs to be submitted to a collection agency at any point in the future.
- Always be aware of the most efficient and successful means of communicating with your patients. You save time, money, and hassle by having patients verify this information.
Improve employee training
Your staff must be on board with your processes once you’ve established well-structured billing terms and techniques and regularly verify your patient information. After that, it’s critical to make sure your personnel is up to date on claims and medical billing coding. This training is critical, and your entire workplace should receive continuous, up-to-date instruction. Designate specific role duties to keep your clinic running efficiently and with few billing issues. BellMedEx has depicted the various processes of medical billing that your team must keep track of.
Your claims will also be considerably cleaner when submitted if your crew is thoroughly versed in medical coding. The industry average for First Pass Acceptance (FPA) claims is only 79-85 percent. However, it would be best to aim for a First Pass Acceptance of 97 percent or greater as a minimum. You’ll have a better chance of attaining that 97 percent if you have a properly trained crew.
- There are numerous advantages to having a well-trained workforce:
- Insurance plans that have been thoroughly investigated
- Insurance claims that have been coded correctly
- Copayments that are precisely calculated
- Uniformity in terms of code and term enforcement
- Medical codes are expertly understood.
Ensure clean claims by improving denial management.
Denials still happen despite a well-trained staff, reliable patient information, and an efficient term procedure. The golden rule is to aim for 97 percent or more clean claims; nonetheless, denials will still occur. Because denials negatively impact revenue cycle management, having a robust response to prospective reimbursement and claim denials can help keep your cash flow stable.
Denials place a strain on your medical practice’s cash flow. When your practice receives denials, the average number of days it spends in accounts receivable rises. Instead of responding to rejections, your primary objective should be prevention.
When dealing with denials, follow these steps to keep your cash flow healthy:
- When it comes to insurance follow-ups, put denials first.
- Respond to denials within 48 hours of receiving them.
- Please make a list of claim adjustments because codes and categories those according to the activities performed to follow up on them.
- Determine explicit language for what types of rejections should be contested and which should be accepted.
- Create a template with uniform phrasing for various types of appeals.
Streamlining Collection Processes with Automation
The risk of human error is always present in manual procedures. It’s too easy to enter incorrect data or send information to the incorrect location.
You don’t need to burden your employees with jobs that can be automated if you’ve up-skilled them. By automating portions of the medical billing process, you can increase efficiency and accuracy. Where should medical billing automation be implemented?
There are several potentials for medical billing automation, but here are a few examples:
The pre-authorization procedure is one area where automation might be advantageous. Pre-authorization issues account for over 11% of denials. You can reduce these types of denials by completing authorization promptly. We advocate automating pre-authorizations that require a medical evaluation so that most requests can be approved immediately if payer conditions are met.
Review of Medical Necessity
By automating medical necessity review, you may take data directly from the electronic health record to complete the assessment fast and guarantee that all necessary data is included. Review of medical necessity cuts down on human mistakes and saves time for your employees.
As a result of the rise in denials, we’ve discovered where they’re coming from. Automating appeals, where possible, is a big-time saver that can help enhance your cash flow. As previously said, developing templates for similar appeal responses saves a lot of time. Automating the appeals process using standard forms and templates is the next step in saving time.
In general, data and automation aid in preventing medical billing errors and omissions. When a process is error-free, it aids collection, boosts confidence, and increases practice income. Furthermore, when reports are more accurate, coders can better predict common billing problems.
Collaborate with a medical billing company to boost collections and cash flow.
Let’s be honest. Medical practices are occupied with various challenges, including ensuring that patients receive the best possible care, upskilling, and maintaining records.
It is estimated that roughly half of all denials occur on the front end, with Registration/Eligibility accounting for most of those front-end denials.
Going a step further, the following are the three most common causes for registration/eligibility denials:
Benefit as much as possible
Coverage provided by the plan
According to these data points, the optimal denial management method is to prevent denials. When they do happen, though, we have some advice. To keep a healthy financial flow, the latest developments and regulations in the healthcare industry, medical billing, and collections are a huge undertaking for your company, and there is a lot to keep track of.
Outsourcing medical billing can help you enhance both your cash flow and your patients’ experiences. Our devoted staff members understand all the ins and outs of the processes thanks to their industry expertise, and they’re ready to face any problems, such as coding errors and underpaid claims.
You can contact BellMedEX to speak with one of our medical billing professionals that provide unparalleled service. We’ll concentrate on optimizing your billing processes and patient collection process. We’ll work with you to improve your billing methods and patient collection process, optimizing income and improving your financial health so you can focus on your patients.