Medical care cost keeps on fluctuating with increase in the medical spending. Healthcare providers and physicians are making their best efforts to provide best quality results in this cutting edge
Still there are some major challenges faced by medical providers when treating complex diseases. The biggest challenges in medical industry are not solely concerned with quality care but have diverted to medical coding and billing.
Most Common Yet Frequently Occurring Mistakes
Approximately $125 billion are left by doctors on the table because of poor medical coding and billing practices. Here is the stark suggestion for all the medical practitioners if they want to become successful in the industry, keep your focal point towards providing optimal healthcare service to your patients.
The most trivial factors that prevents you from proper reimbursement.
- Billing errors
When it comes to coding practices and medical billing, insurance companies gets really strict about them. Around 80% medical bills have errors in them. If the insurance company discovers any error in your claim, then the claim process begins again. This will prevent you from getting reimbursed in a proper manner and you’ll have to wait for several months.
- Staying updated with rules and regulations
Rules and regulations are changing constantly in the healthcare industry. All the medical practitioners have to spend their time and money in educating, training the staff in new practice management software and staying updated with the major changes that affect the profit and cash flow of practices. Remaining in touch with major changes and timely updates forms the base of your thriving revenue cycle. For instance, with the Health Care Reform bill have raised the number of American population who got insured. This makes proper medical coding and billing procedures more crucial than ever.
Medical practitioners face problems while tackling with the unique rules and regulations along with changing coding standards. Underpayments, claim denials and ignored claims are adding into the burden of maintaining a thriving revenue cycle.
- Third Party Solution
There are few outsourcing companies that charges a few percentage of the revenue collected. This makes your revenue collection more diligent for submitting claims and faster collections. Your medical staff might not have the time to go through the denial claims and generate a new one. A booming revenue cycle is directly proportional to getting paid for rendered services.
- Claims on Daily Basis
Keep in mind, never wait for the insurance company to pay you. Make sure to bill out on daily basis. Even you can form a system to keep follow-up in place for your outstanding claims. Try to ensure that claims are getting paid in the very first submission. This can only happen when you know in advance what are the requirements of insurance company on individual claims.
- Make patients part of your rejection and follow ups
This three way calls mostly results in highly effective and positive outcome. In case your call is static then escalate it to the supervisor level.
- Creating Measurable and Standardized Billing Process
The best way is to make a flowchart delineating billing and collections steps. Once you’re done with making chart, assigning right staff for every purpose. Make sure to train the staff in their assigned jobs.
Follow these steps to avoid your staff from baffling while managing your revenue cycle. You can opt for outsourcing decisions who are expert in following these tips for maintaining a flourishing revenue cycle.