I don’t need to tell you how complex the medical billing revenue cycle is. Managing and collecting payments for doctors, hospitals, and even healthcare systems can be a tricky affair, with plenty of moving parts. Each of the following represents an interchange where revenue can fall through the cracks: patient registration, insurance & benefits verification, insurance prior authorizations & claims filing, medical coding, charges & payment posting, denials management, and report generation. When appropriate scrutiny is not given, thousands of dollars can be lost.
The Shortlist To Reduce Your Practice’s Revenue Leakage
1. Address Personnel Problems
Ensuring that all personnel, from your reception desk to your billing department, are trained properly and undergo continuing education helps to reduce mistakes & inefficiencies. The front desk must take accurate data while showing patient’s empathy. All of your employees should understand how to submit bills as well as how to follow up on the billing process.
2. Prevent Denials Related To Credentialing
Denials due to credentialing are one of the simplest problems to address. Outsourcing to a credentialing company can ensure that all claims are properly filed before the issue happens. The presents waste time and speeds up the revenue process.
3. Strategic Claim Denial Management
Maintaining or hiring a team to handle denials can be an incredible stem to revenue leakage. This particular issue requires a team that is constantly staying abreast of changes in procedures with each of the insurance companies. Understanding why refusals happen and how to correct the issue swiftly is imperative.
4. Spend Time Managing Your Patient Relationship
People should always remain the core of your business; therefore, patient care should always be top of mind. Being clear and transparent while allowing for maximum flexibility in payments helps keep customer satisfaction high. This positively affects repayment and ensures maximum reimbursement.
5. Prevent Un-Billed Procedures
Taking steps to ensure that minor procedures which are associated with larger procedures are not overlooked can be an important step in stemming revenue leakage. Making sure this knowledge isn’t sequestered to specialists is paramount.
6. Prevent Un-Billed Claims
Un-billed claims are one of the biggest revenue drains, and it’s solved by ensuring that a patient’s history is comprehensive and referenceable by all departments. Double-checking patients’ appointments and procedures against their submitted claims can virtually eliminate this type of loss.
7. Manage Patient Balances Closely
Put together a process to manage patient balances efficiently. This process should include texts/notices, multiple payment methods, and payment plans. The easier you make paying, the more likely you are to ensure maximum repayment.
8. Utilize Analytics Fully
There is plenty of software available today to manage and report on your revenue cycle. Paying attention to the available software features and utilizing them regularly can help unearth costly financial and operational performance issues early.
9. Prevent Underpayments
Understanding the real and exact costs of your services can be a big revenue source. With proper guidance, you can keep your fee schedule in sync with the different insurance groups out there and never undercharge when prices shift quickly.