In the complex landscape of medical billing, understanding the key elements that affect payments and the revenue cycle is paramount for the financial well-being of healthcare practices. This article delves into the intricacies of medical billing by shedding light on four vital elements that significantly impact payments and income cycles. From accurate coding and efficient claim submission to effective insurance verification and robust patient communication, these elements are the linchpin in optimizing revenue and ensuring a smooth financial operation within the healthcare industry. Whether you’re a medical practitioner or a billing professional, exploring these factors is essential for navigating the intricate world of medical billing successfully.
The recent changes in the U.S healthcare system have brought with it variety of challenges for healthcare units, patients and insurance companies alike. Staying afloat in such a transition can be a tough task, while the frequent alterations of medical billing and coding rules and regulations, can cause income loss.
Crossing the Hurdle
Though economist of our nation paint a dismal picture of the financial health of our industry, there is still hope for all the stake holders in the field. To cross the hurdle healthcare units are taking a more proactive approach to their billing procedures. By resolving the income cycle issues healthcare units can maximize their revenue, while ensuring they are properly reimbursed.
Here are four vital elements that affect your income cycle:
1. Create a Collections Process
All medical facilities. Big or small need a clear cut collections process to make sure that the financial health of the practice remains stable. Creating a step-by-step collection process simplifies the procedures for all the involved parties, and it can greatly improve the income cycle by ensuring patients are thoroughly informed of their responsibilities.
2. Handle Claims Properly
More than 70% of all medical bills contain errors. Due to this very problem and strict insurance company’s laws about correct medical billing and coding best practices, they are bound to be rejected. The full claims cycle that consist of submission, rejection, correction/editing and resubmitting can take weeks. Because of the lost time and effort wasted in editing and resubmitting claims, it’s vital that claims are accurately submitted on the first go. If the in-house staff in falling short of performing those duties, you can always connect with medical billing and coding service provider who can double-check claims for any errors before submitting.
3. Coding Errors are Serious
Coding errors are in the top 5 reasons, as to why your claims get denied. As a professional medical coder it is a duty to describe the performed procedures using standardized codes, making it easier for the claims to decipher and process. While this provides a standard method of describing procedures, errors can still occur. The most common errors, such as incorrect, mismatched, or missing codes, are often caught by clearinghouses before they become an issue. However, some common errors are more difficult to catch.
4. Why not outsource?
Outsourcing your income cycle and revenue management tasks to a professional medical billing service provider makes more sense doing it in-house. The staff working are experts in working through pressure situations with insurance companies to get reimbursed till the last cent. As a certified medical billing and coding company in the United States, we work directly with the physicians who receive requests for additional information from insurance companies.
Another reason to outsource is that you are relived from the task of having your staff trained constantly to efficiently execute the billing procedures. With this transition you and your employees will be free to provide the best quality service to patients.
