A successful medical organization no matter how big or small, it always requires a team of experts who can look at the administrative and financial side of things. This takes off the workload from the medical professionals’ shoulders thereby allowing them to focus on their patients’ treatment. One of the most important aspects of any medical practice is healthcare billing. If you are looking for some medical billing tips then you have come to the right place, read on and by the end of it you will know everything.
For a medical practice to stay financially healthy it is very important that the revenue cycle management is done in a proper manner. Not only must a medical practice deliver its promise of providing top-notch care and service to its patients but also take good care of the business by earning profit. It is of vital importance that the RCM is micro-managed by a team of experts in order to bear the expensive burden of providing great healthcare services. This part can be especially challenging since medical practices get reimbursed by insurance companies only when the filing of claims turns out to be accurate.
When insurance claims are not filed on time or contain many errors then it can lead to delayed payments which results in the loss of the hospital itself. Therefore, to avoid that they must hire a third-party organization that can provide adept individuals who are well-versed in the field of medical billing. The field of medical billing is constantly evolving and changing therefore having a team of professionals who keep themselves updated on every little change that comes about is always helpful in the success of the medical organization.
Important Things to Know About Medical Billing
In order to cut down on your losses and streamline all of the billing procedures, it is important to know some medical billing tips that can help your practice in the long run.
1. Comprehensive understanding of the process of medical billing and coding
It is normal to feel intimidated and overwhelmed by collections and billing procedures. However, having an idea about the entire process makes things easier. This way even if you trust a third-party company with this you will still be able to stay updated with the filing of claims, submission dates et cetera which makes little to no room for fraudulent activities.
The medical billing process starts with the verification of insurance eligibility and the collection of the portion from the payments (deductibles, co-insurance and co-payments) during the time of the service being provided. Medical professionals are responsible for providing the coders and billers with the specific diagnostic codes for the treatments given to the patients.
The claims that are therefore coded get uploaded into the management software and after all the required steps get submitted to the insurance payers. The insurance companies therefore then decide whether to reject or accept the claims.
2. Skilled staff
Once you have a medical claim billing process that is measurable and standardized in nature, it is crucial to have a skilled set of employees who can implement it easily. When you are hiring from a third-party organization it would not be wise to skimp this step. For a revenue cycle to be healthy the key is to have a fully trained staff at the front desk because the RCM starts with the patient scheduling a doctor’s appointment.
The front desk staff looks at the benefits and eligibility of the patient and also collects the balance before or after the service is provided to the patient. A flowchart of all the steps that are required in the collection and billing is also useful. The flow chart should have a proper description for each of the steps quite thoroughly for an easier understanding.
3. Have a goal set in your mind
Once the process of billing is understood, examining the issues that can impact the process of medical billing cycle and properly identifying the step with which you can proceed will help your organization in the long run. Many medical practices tend to overlook the denied claims or the overall payment which can be quite detrimental to the process of medical billing.
A thorough dissection of all the billing KPIs (key performance indicators) will help you to create a proper strategy that can be implemented in the revenue cycle management. This will provide a boost to your organization’s growth in the long run.
4. Submission of claims
It is important that the claims get filed in a correct manner in order to ensure that the payments are received on a timely basis. Even though ACA and HIPAA regulations have a national set of codes for electronic healthcare transactions, there are a number of edits and rules that must be kept in mind while the process of healthcare billing is under process. While filing the claims it is key that every bit of information is included in it or it can get rejected. Regular claims scrubbing is also something you need to keep in mind. It includes the identification and rectifying of all the errors that might be present in the billing codes.
This helps in the generation of accurate claims where the denial rates get reduced and also improves the communication with the insurance payer.
5. Make use of technology
Technology plays a major role when streamlining of medical billing is concerned. Not only does it allow the patient party to make digital payments but also the latest medical software focus on connecting different departments of a medical organization which makes the workflow smoother.
Medical software these days help in the automation process during medical billing such as checking the rules of the insurance payers before the claims are submitted, suggesting the respective medical codes, and many more.
It is only through open and consistent channels of communication with all of the patients’ insurance parties that you will be able to achieve the groundwork required for an uncomplicated resolution. If you’re looking for a reliable service provider for medical billing and coding, you can definitely rely upon Synergy HCLS.