The latest updates in the US healthcare system have brought a plethora of new challenges for both patients and medicare providers. The introduction of a value-based and time-consuming compensation model and intermittent alteration in the healthcare policy can cause a significant revenue loss to the medicare providers across the USA.
Failure to stay up to date on the ever-changing medical billing rules and regulations and medical billing and coding errors, result in medical practices leaving up to $125 Billion in overall uncollected revenue. Specialized medicare care providers like Radiology may face even greater challenges owing to the complexity involved in their procedures and billing process.
In medical billing, a lot of things can go wrong, however, if you are rigorous in establishing definitive standards for your staff to adhere to and follow a clear-cut and defined approach towards patient’s payments, you can efficiently cut down on errors and missing payments.
Medical Billing Tips To Help Your Practice Over The Hurdle
When it comes to medical billing and coding you have the option to conduct it yourself in-house or you can outsource this complex responsibility in the hands of third-party experts. If you intend to take care of your medical billing and coding procedures there are a few experts recommended tips that you need to know.
Here are 5 highly effective medical billing and coding tips that will quadruple your revenue collection and minimize risks in any sort of practice.
1. Establish a clear step by step revenue collection process
Having a well-defined collection process is crucial for the financial health of your medicare organization. A step-by-step approach ensures that all involved parties are well aware of their responsibilities. Moreover, this way your patient will be properly and thoroughly informed of their responsibilities. Here are a few steps that every collection process should have:
- Inform patients of their responsibilities: Before filling you have to inform patients of what is expected of them in terms of payments. Include these terms as a part of their new patient paperwork and remind them at regular intervals, in this way they can’t claim ignorance as an excuse for their delinquency.
- Diligently collect patient information: Your medicare organization has to retrieve as much information as possible about the patient. Be sure to collect their photo ID at their first visit along with their address, email, workspace, phone number, etc.
- Verify the contact information of your patient: Check with the patient at regular intervals to ensure that their contact information has not changed.
- Get permission to leave messages: Include this term in their new patient agreement that you can leave messages regarding their billing matters.
- Remind patients about their co-pays: Do remind your patient about the importance of co-pay. Moreover, you have to ensure that your staff is trained enough on this matter to answer patients’ queries.
- Verify insurance eligibility to avoid claims denials: For every visit, remember to verify the eligibility of their insurance service. You can use an automated verification system to save on labor costs.
- Collect upfront: collect all copays and other dues based on their deductible upfront. So that you can avoid labor involved in chasing them down later.
- Send letters: send letters to the patients whenever their payments are overdue. Some patients require several reminders before acting.
Although this process seems a bit detailed and time-consuming, implementing a proper revenue collection process scan helps medicare practices avoid repercussions.
2. Avoid medical billing errors
As per the research, 80% of all medical bills contain errors. As you know how strict insurance companies are about strict medical coding and billings, they are likely to get rejected. The never-ending cycle of submission, rejection, editing, resubmission, rejection… takes weeks and sometimes months. So, it’s important that all medical bills are accurate and complete at the first submission. Here are a few medical billing errors that you should look for.
- Incorrect provider information
- Incorrect patient information
- Duplicate billing
- Incorrect insurance information
- Poor documentation
- Missing or unclear denial codes or claim number references on a denied claim
- No EOB on a denied claim
To avoid billing problems, be sure to double-check claims before submitting them and communicate with the rendering provider if any information is incomplete, inconsistent, or unclear.
3. Minimize coding errors
Medical coders make use of easy-to-decipher and standardized codes to describe a procedure. These codes can use CPT, HCPCS Level II, and ICD-10-CM classification systems.
Although Using codes is a standard method of describing medical billing procedures, errors can still happen. Some common errors are mismatched, incomplete, or wrong code. They are often caught by clearinghouses before they become an issue. There are some coding errors like non-specific diagnosis code and incorrect modifiers that are difficult to catch. The upcoding and under coding errors whether they are intentional or accidental are also likely to happen.
Before submitting a claim it’s pertinent to double-check your claims. If a procedure description is ambiguous or contradictory, always contact the provider before assigning a code to avoid upcoding or under coding errors. To ensure that the code is correct, always cross-check with medical coding resources.
4. Look for ways to improve
Healthcare is a consistently evolving field, practices should keep up with these changing trends if they want to maximize their medical billing efficiency and revenue. By tracking the underlying problems and staying up to date on the latest healthcare rules and regulations you can implement new ways of addressing them.
To ensure optimum accuracy and efficiency, medicare practices should take the following steps:
- Track your outstanding amount: Tracking the outstanding payment plays a pivotal role in determining the effectiveness of your collection procedures. You have to track the amount from quarter to quarter and compare these figures to those of previous years. This way you can know the impact of newly implemented procedures.
- Stay up to date: As already mentioned, medical billing is a continuously evolving field and you have to constantly keep up with these ever-changing trends. For this, your practice requires adequate education and training as well as software updates. Stating on top of medical billing and coding updates is less costly than repeatedly resubmitting claims.
- Identify potential challenges: You have to identify and implement new ways to track problematic behaviors like frequent changes in contact information or regularly declined payments to better target patients for additional reminders.
5. Know when to outsource
Medicare staff has to worry about current trends in medicine, their patients, and proper staff management. Along with that, they may also have to worry about the current medical billing and coding trends, insurance companies, and billing regulations. With this much on their plates the details can easily slip through the cracks, which results in denials, rejections, and underpayments, this costs medical practice a lot of time and money.
To comply with rules and regulations and to cut labor costs, many practices prefer to outsource their medical billing to experienced third-party specialists like Dominion Revenue Solutions.
Here are a few benefits of outsourcing medical billing to Dominion Revenue Solutions:
- Medical billing specialists: Medical billing and coding companies like Dominion Revenue Solutions have a dedicated staff of experts whose job is to ensure that your claims are filed accurately. This results in reduced denied claims because of their specialized experience and duties.
- Fast Submissions: Highly trained staff members can easily submit your claims much quicker and with higher attention to detail.
- Patient-focused approach: Once you have eliminated the time spent on billing and staffing your staff can better focus on their core objective.
- Stay up to date: Dominion Revenue Solution is compliant with all the most recent health care laws so they can stay up to date on most current regulations. In this way, they can meet the changing demands of serving hospital-based specialty practices.
With Dominion Revenue Solutions, you can manage all of your billing activities online and outsource some of your processes to dedicated professionals. Learn more about our services by visiting our website today!
