Updated: Aug 1
Few would contest the fact that a medical practice's success depends on its ability to manage its revenue cycle effectively. In the healthcare sector, we face the additional difficulty of frequently receiving payment from a third party after the patient has received treatment. Furthermore, it will be expensive and time-consuming to get that reimbursement if a claim is rejected by the patient's insurance provider. For many years, ProMD Practice Management has offered billing services to medical professionals. We've compiled a list of the most crucial actions you can take to ensure that your revenue cycle runs as smoothly as possible and that money continues to come in.
Create a System
The billing team only needs a brief outline to compare their work to, preferably in writing. It should outline all of the critical actions that must be followed to correctly complete a claim form, from confirming coverage to closing and stamping the envelope. Post the outline where the billing team is employed so they can access it whenever they are preparing a claim. Errors can be drastically reduced by taking this one step.
Although we won't claim that insurance companies actively seek grounds to reject your claim, there are a number of reasons why they might. Make sure your billing team is submitting accurate claims. That indicates that the bill is timely filed and that all of the information on it is accurate. When entering diagnostic and therapy codes as well as patient demographics, common errors happen. Some medical facilities use a "scrubber" whose main duty is to evaluate claims one last time before they are submitted.
Many of the medical facilities with whom we have worked designate one day of the week to process all of the claims. Think about submitting claims every day. You don't want a deadline to slip by as you wait for the billing day to return the next week. Additionally, daily billing prevents the billing team's workload from growing too heavy with claims. Make sure to work on denials and other issues every day as well.
Uphold your agreements
This connects to what we said earlier. Insurance companies are not aiming to take advantage of you, but you shouldn't expect them to go out of their way to compensate you either. Make sure you and your billing team are aware of the agreements you have with each payer and hold those businesses accountable. If you believe that your practice is correct, challenge denials and ask your employees to escalate the issue if required to obtain a resolution.
Your Patients Should Be Involved in the Claim Denial Loop
The insurance client may occasionally be able to complete the task. Don't be scared to ask your patient to speak up on your behalf with the insurance company if they believe a refusal is unfair. Three-way calls that include the patient on the line have proven to be quite successful in attracting the insurance companies' attention. Just make sure you've taken all the necessary steps on your end before using this strategy.
Outsource your Billing
Dealing with insurance companies doesn't have to be stressful for you thanks to a reputable billing firm. Your claims will be submitted accurately and on time since they make it their business to stay current on any changes to payer policies and billing standards. You can identify an excellent one by asking your coworkers who they use and how happy they are with the service. You might actually end up making money thanks to the higher collection rates and the less workforce. Billing services are one of our areas of expertise at ProMD Practice Management. You can select a la carte services or let us handle all of your billing needs. Claim rates for our billing clients reach as high as 98%. Phone ProMD
In order to maximize earnings and improve patient happiness, ProMD Practice Management is delighted to assist you with your billing assessment needs. Call 888-622-7498 or use our online form to get a billing assessment to find out more about how ProMD can help your practice function like a well-oiled machine.