These days, the healthcare industry is experiencing a great deal of change in terms of the coding, regulatory, and federal laws that are in place. Due to the frequency of these changes, medical practitioners and other office staff members who are responsible for medical billing must remain vigilant and participate in ongoing training and skill development. Even though electronic medical records (EMR) and more advanced software for practice management have made the process easier for practices, there is still a high rate of claims being denied.
According to sources within the industry, improper billing procedures result in the loss of approximately thirty percent of the total revenue that could have been collected. The errors in coding or billing that result in claims being denied or rejected account for a significant portion of the revenue that a practice loses. Optimizing the medical billing services provided by your practice is the most effective way to steer clear of situations like these.
The following is a list of the top five tips to optimize medical billing services in your practice, which would ultimately lead to an increase in revenue for your practice.
1. It is important for practitioners to define their Administrative and Financial Responsibilities
Before beginning their work and make a step-by-step plan for how they will manage those responsibilities before beginning their work. If you choose to handle billing internally, you will need to recruit and educate a sufficient number of employees, as well as invest in the most up-to-date hardware and software.
In addition to these, you are also required to acquire an in-depth knowledge of the policies and standards imposed by the payer. It is best for practitioners who are looking for simple and well-planned solutions for billing services to outsource medical billing from one of the many companies available. A lack of proper planning can result in last-minute delays as well as an inconsistent flow of cash.
2. It is important to avoid making coding errors
Because medical coding serves as the foundation of the medical billing and revenue cycle. A straightforward coding error can lead to the rejection or denial of a bill, which in turn can result in a loss of long-term revenue for your practice. Even though coders put in a lot of effort to reduce the likelihood of errors, common errors such as incorrect, mismatched, or missing codes frequently result in incorrect billing.
Optimizing the revenue cycle is the most crucial step you need to take if you want to see an increase in income at your clinic. Streamlining the management of the revenue cycle is one way that this may be accomplished. Improving revenue cycle management may be helped by doing one or both of the following: increasing cash flow or minimizing operating expenses.
In order to streamline and improve the effectiveness of the revenue cycle in your practice, you should keep a close eye on the billing details, account receivables, and patients who are late with their payments. In addition to this, it is of the utmost importance to keep a close eye on the financial performance of your practice on a consistent basis, as well as to devise and put into practice innovative strategies for expanding revenue streams.
Therefore, ensuring that medical coding is accurate should be the first step in optimizing the revenue cycle. Always use the services of a certified coder who is well-versed in the ICD-10-CM, CPT, and HCPCS level II classification systems. This is the best way to ensure that your claims are processed accurately. Claims that are rejected less frequently and are reimbursed more quickly when the coding is clean and accurate.
3. Maintain efficient Denial Management
Denials are an inevitable part of the billing process; even the most experienced and accurate billers will run into them at some point or another in the course of their work. Therefore, it is essential for practices to ensure that their systems are equipped with an effective denial management plan. It is essential to investigate the claims that were rejected and search for potential explanations for the rejections. This makes it easy to rework denials and prevents further denials for the same reasons that caused the previous ones. Reworking and resubmitting previously denied bills in a timely manner both prevent loss and bring in more revenue.
4. The majority of practitioners believe that submitting claims
The most important task in the revenue cycle, so it is essential that you learn how to follow up on them. After the submissions, they put the responsibility for payment on the payers. However, maintaining a consistent line of communication with the payers or the insurance agency is also of equal significance. There are times when insurance companies give certain groups’ claims higher priority than others and put the others on hold. In situations like these, performing regular follow-ups is effective and helps speed up the processing of claims.
Regular follow-ups not only protect your practice from claims being denied or rejected due to a lack of supporting documentation, but they also almost certainly result in an increase in revenue for your practice.
5. Streamline Revenue Cycle Management
The most important step for increasing revenue in your practice is to optimize the revenue cycle. This can be done by streamlining the management of the revenue cycle. Increasing cash flow and decreasing operational costs are both helpful in improving revenue cycle management. You should keep an eye on the billing details, account receivables, and late payers in your practice so that you can streamline the revenue cycle and make it more efficient. In addition to this, it is essential to monitor the financial performance of your practice on a regular basis and to develop and implement new methods for increasing revenue.
It is critical for the growth of a practice’s revenue to focus on improving the efficiency of its medical billing services. It is helpful in improving performance as well as identifying possible lags. You can improve the efficiency of your billing process by contracting out the work to professional service providers who offer medical billing services. They have a lot of experience with handling billing, so they are familiar with all of the potential areas of negligence. Selecting the most suitable outsourcing company will unquestionably optimize the billing cycle of the practice and bring in an increased amount of revenue.
