Medical billing is critical to the financial health of a medical practice. When billing errors occur i.e, not enough patient data, wrong coding, incorrect or missing information, and incorrect procedure codes. It will result in significant revenue loss and other financial crises. Sometimes, even a slight mistake (bundling, choosing wrong code) can put your business at risk i.e, federal penalties, reputation damage, and dissatisfied patients.
However, the accuracy of billing and claim processing is very essential. Healthcare practitioners must understand the fact that the success of medical claims is in the hands of their billing staff. If billing staff is well-trained, detail-oriented, and stays up-to-date. Then, they are in the right direction. If they are not fully trained and fail to stay updated on changing billing regulations. Then it’s the right time to train them, that helps to avoid billing and coding errors.
It’s essential to learn how to not only identify the most common billing mistakes but understand the proven way to handle them. Because medical billing is often the lifeblood for a healthcare facility’s revenue stream. That’s why anything that can lead to an increase in billing errors needs to be recognized and rectified as soon as possible.
Here are the following efficient ways that help to minimize billing mistakes and improve clean claim rates. Which results in improved the overall reimbursement rate and streamlined cash flow.
Complete all the necessary fields of your medical bill: It has been estimated that approximately 61% of initial medical claim denials are due to submitting a medical bill with incorrect/missing patients’ demographic data and inaccurate insurance plan code.
Thus, it’s essential for your front-end staff to collect accurate and complete information from the patients. And perform due diligence before processing a medical claim to an insurance company. This means verify or double check all information i.e, patient name, birth date, policy number, and all pertinent information that is needed in the claim form.
However, in the procedure information and coding, claim scrubbing tools play an essential role in catching common billing and coding errors. Which helps to minimum denials and improves overall clean claim rate.
Implement technology-driven solutions: Traditionally, medical billing and coding is a very time taking and frustrating aspect of a healthcare facility. On the other hand, it plays an essential role in managing the revenue cycle of a healthcare facility.
That’s why healthcare service providers always look for innovative ways to streamline their business financial operations and boost their productivity. One method for doing so is utilizing cutting-edge EMR/EHR practice management systems in the billing process.
Digital technology has significantly helped in wide medical functions i.e, timely diagnosis or treatment, medical billing/coding, data collection, compliance with health regulations, and remote monitoring.
However, the greatest advantage of utilizing an integrated system is streamlining each function, such as
- Reducing paperwork.
- Better patient scheduling.
- Help to maintain a clear and complete patient record.
- Improve healthcare practice efficiency.
- More thorough documentation.
- Quickly verifying the insurance eligibility.
- Help to track the status of medical claims.
- Eliminating mistakes/errors that can affect the entire billing process.
- Remote coding
- Medical claims are processed faster.
- Better reporting.
- Higher reimbursement.
However, the data in a patient’s EHR/EMR only has to be entered once, so the potential for mistakes is virtually eliminated or significantly reduced.
Use the latest coding manual: Medical coding guidelines, regulations, and laws are constantly changing. If a healthcare practice uses an outdated reference manual it will result in denials that negatively impact the reimbursement process.
It’s essential that a healthcare practice medical coders are always up to date with the latest billing regulations and rules. To refresh the coding strategies they need to undergo constant training and use the latest coding manuals i.e CPT & ICD-10 codes.
So, by staying updated on all these coding changings healthcare providers can have seamless processing of medical claims in time without any revenue loss.
Filing claims within designated deadlines: Every insurance company has a different time limit on claim submissions. That lasts between 60 days to 1 year. If a medical claim gets rejected or denied a healthcare practice has an additional 30 to 45 days time limit to appeal that medical claim.
If a denied medical claim is not filed on time it usually results in write-offs and accounts receivable. This is considered a costly mistake- this means thousands of dollars uncollected on the table.
That’s why healthcare practitioners simply need to create a system in which their billing team receives automatic alerts as healthcare bills approach their time limit.
Also, to avoid missing these deadlines medical practitioners need to set up time-sensitive tasks for billing staff to audit unfiled medical claims.
Hire Billing specialist: If it’s difficult for healthcare providers to manage billing procedures in-house. Due to lack of proper billing tools and well-experienced billers and coders. Then outsourcing medical billing services to an expert billing company is one of the best decisions.
By outsourcing, healthcare facilities can avoid mistakes that are caused by inexperienced coders and billers. Because the medical billing company has fully-trained and certified billing staff. Who always stay updated on coding regulations and ensure a 100% clean claim process.
This also ensures that your staff will no longer need to spend time on these medical billing tasks. They collect underpayments and overdue payments both from payers & patients on the healthcare service provider’s behalf. And ensure a streamlined revenue cycle management process.
There are many other benefits of hiring a medical billing company.
- Vast medical billing expertise.
- It eliminates all pain points associated with medical billing.
- Reduce the risk of medical billing errors.
- Enhanced Transparency
- Fast insurance payments and reduce overhead costs.
- Reduce administrative duties.
- Ensure compliance.
- Easy to integrate with your existing EMR/EHR systems.
- More focus on patient care.
No doubt, medical billing can be complicated. But when you perform billing tasks accurately and in a timely manner. It will significantly improve your practice’s overall reimbursement rate and cash flow. All you need is employing a certified or well-educated billing staff. Who is efficient, diligent, organized, and thorough.
If you find it challenging to manage medical billing services in-house. Then outsourcing is the right decision. That you can make to improve your business’s overall financial operation and growth.
Disclaimer: The statements, opinions, and data contained in these publications are solely those of the individual authors and contributors and not of Credihealth and the editor(s).
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