Quality of healthcare is undoubtedly the first and foremost objective of every medical practitioner. But one can’t deny the fact that offering standard medical aid is not enough to keep your healthcare business financially stable.
Medical practitioners need a streamlined revenue cycle management to chase their financial goals. For this purpose, they should pay special attention to the non-medical obligations i.e billing, coding etc, of their business.
Because an inefficient medical billing system cannot only result in revenue loss and financial crisis. But it also negatively impacts the overall business operations, particularly forestall the financial growth of the medical practice.
Financial issues can arise due to a variety of reasons. Such as: lower customer retention rate, increasing revenue backlog, and not getting timely reimbursements for the healthcare services rendered. So, in order to scale up your growth level at higher levels, medical practitioners must implement innovative solutions.
More importantly, they should shift their focus to optimize the revenue cycle management. Because maximum billing collections are highly dependent on streamlining the following RCM factors including:
- Patients’ scheduling.
- Prior authorization/ Insurance Verification.
- Patients’ information collection.
- Charge entry.
- Medical coding.
- Claims preparation and submission.
- Follow up with the insurance companies.
- Denial management.
- Payment posting.
- Medical accounts receivable recovery.
All these above-mentioned tasks are complicated and time-consuming. But you cannot ignore them, because negligence at any RCM stage can result in claim denials. And healthcare providers ultimately lose their hard-earned revenue.
Are you struggling with constant revenue leakage and don’t know about the core reasons? Then you must analyse the medical billing process to identify the root causes that slow down your revenue. So, identification and resolution of common mistakes is the first step towards increasing your billing collections.
Here are a few mistakes and their solutions to elevate your billing collections:
1. Failure to Capture Accurate Information
Incomplete or incorrect patients’ information including: name, date of birth, gender, age, address, phone, number, insurance information etc, can lead to claim denials.
These errors occur when your registration staff fails to collect the patient’s data comprehensively. Even a minor error in this information can hold payers back from reimbursements.
In order to remove the root causes of claim denials from the beginning, you should streamline your front desk operations. If you still rely on orthodox methods to capture patients’ data, then you must implement automatic solutions. Because manual methods of information collection and processing always leave a huge room for human errors.
For this purpose, medical practitioners should implement EHR solutions. Electronic Health Records can help you provide higher quality care for patients as well as keeping medical records in a secured manner.
EHRs can benefit your medical practice in the following ways:
- Provide completed and updated information about the patients while delivering care services as well as claims preparation.
- Allow quick and authorized access to patients’ records for more efficient medical billing services.
- Improves the interaction between the patients and healthcare providers.
- Ensure legible and accurate medical documentation.
- Enhances privacy and security of patient data.
Having a record of accurate and complete data eliminates the chances of duplicate claims, data entry and other human errors. Which ultimately increases the efficiency of medical billing services and speeds up the revenue collections.
2. Invalid Insurance Information
As the patients’ insurance coverage can change due to certain reasons. Failure to verify the patients’ insurance information at every visit can create hurdles in payment collections.
Because it might be possible that a clients’’ insurance policy has changed and you aren’t aware of it. So, if you process the claims with outdated/invalid insurance information. Then claims get denied and healthcare providers lose a significant amount of money.
However, you can avoid such inconvenience by ensuring that your front desk staff verify current insurance coverage. And determine whether or not the services about to be provided are covered under the patient’s existing insurance plan. You should ask your patients to bring their updated insurance cards at every visit.
3. Wrong Set Of Medical Codes
Medical coding isn’t just crucial for the maximum reimbursements. It is also important to save your practice from billing frauds. Because some coding errors such as: using the medical codes for the more or less expensive healthcare services are considered as malpractice. That can result in federal penalties and sometimes even imprisonment.
Moreover, staying updated with coding evolutions and the transformation of a particular injury in standard medical codes isn’t an easy task. Thereforye, medical practitioners should never rely on inexperienced staff for this responsibility.
For this purpose, you acquire the assistance of certified medical coders, having a wide range of experience in your medical specialit. Furthermore, make sure that each diagnosis code exactly matches the procedure that is actually performed.
4. Inappropriate Claims Management
Most of healthcare providers feel overwhelmed and frustrated due to the high rate of claim denials. Because a high percentage of denied/rejected claims can lead to a critical financial crisis such as: cash flow disruption, revenue loss etc.
Healthcare providers should always keep in mind that well-organized management of medical claims is the key to streamline the revenue cycle management.
Particularly, keeping up with deadlines are critically important in the claims filing process. Because failure to submit the claims in a given time window of payers is one of the major factors. That eventually results in claims denials.
The best way to avoid revenue loss is the timely submission of clean medical claims. You should implement electronic billing solutions to improve the efficiency of insurance claims.
But it’s a fact that due to the latest evolutions in the healthcare industry, managing medical billing has become extremely complicated. We have already discussed that without the assistance of highly trained billers and coders, you cannot streamline this process.
However, instead of investing a significant amount of time and money in hiring an in-house billing team. Healthcare practitioners should consider outsourcing medical billing services. In this way, you get the services of well-trained and professional medical billers, having in-depth knowledge about all billing and coding standards.
Hence by filing the clean medical claims and streamlining the overall RCM tasks, they eliminate the inefficiencies in the process. Moreover, outsourced billing experts collect the maximum revenue on your behalf and elevate the profit margins of your healthcare business.
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