Because of recent changes that have occurred to the healthcare system in the United States, medical providers and patients alike have new challenges to overcome. There are many parts of healthcare reform that can end up causing revenue loss, such as compensation models that are more focused on value, as well as the constantly changing rules that come with medical billing. While all of this can cast an ominous shadow over the medical billing industry, we want to assure you that providers can still hold hope. Here are medical billing procedures that can help your practice stay more proactive and incur more revenue.
Create a Clear Collections Process
To keep their practice’s financial health going strong, providers must have a well defined collections process. Using a step-by-step method, all procedures for every stakeholder can be clearly identified. When patients know about all their responsibilities, it can do wonders for your revenue cycle. There are a few steps that all collections processes should have.
There should be clear terms established. Patient information needs to be gathered, and there should be an agreement included that allows providers to send messages for all billing concerns. All addresses need to be verified. Patients should be reminded about their co-pays, and these co-pays should be collected upfront. There should be letters sent to patients if their bills will be due very soon, if they are overdue, or if they will be sent out to collections shortly. Lastly, you should make it clear which payment options are available, as well as what forms of payment they can use.
Manage Claims Properly
Insurance companies are incredibly strict about making sure all billing and coding practices are followed. It is common to have medical claims rejected by an insurance company. It can take a huge amount of time to have a claim rejected, then edited, and then resubmitted, so it’s best to know what can cause rejections, so you know how to avoid them. Here are some likely reasons a medical claim could get rejected:
- Wrong provider information
- Wrong patient information
- Bad documentation
- Unclear/missing denial codes on claims that were denied
- Duplicate billing
- Wrong insurance information
You want to check all of your medical claims multiple times before you send them out. Also, keep in touch with your rendering provider so you can inform them of information that is either unclear, missing, or inconsistent. Once the claim gets submitted, you should take the time to follow up on your submission by speaking to the insurance company’s representative and stay current on all errors that are found.
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