With recent changes to the medical and health industries in the United States due to pandemic or say federal changes, it has become even more challenging for the physicians and doctors to keep their revenue management cycle steady. The healthcare system amendments have not only affected professionals but patients in the same boat.

Healthcare reforms such as the value-based compensation model, requirements of spending more time performing duties, and never-ending alterations in the billing process are important factors of revenue losses. Many times not hiring medical billing services providers, failure to upgrade the process of claiming bills, regulations, rules, and errors in billing make medical providers lose around $125 billion of their revenue annually.

In addition, specialists such as radiologists have to face even bigger complexities when it comes to adhering to prerequisite needs for billing and the process. Therefore, it is high time that practices need to refrain from hurdles to improve their revenue cycle.

Improve Your Practice Revenue By Implementing These Strategies

One might feel daunted about the data defining the health of the medical industry in the United States. But there’s a light of hope for the providers in the United States. To render the compliance risks and financial issues, practices need to take more proactive approaches to maintain their billing procedures. These approaches include reducing errors from occurring, by ensuring that the bills are properly reimbursed so they can continue the provision of their services timely and accurately.

Here are some steps that healthcare practices should proactively apply in their medical procedure;

1.  Adopt a Clear Collection Process

To understand revenue steadiness, all practices need to make healthy changes to their financial process. Preparing and following a step-by-step approach that simplifies the involved procedure can evenly improve revenue and ensure that patients are properly informed about their liabilities.

A few steps are involved for a smooth collection process;

• Establishing clear terms – Keep your patients notified about their financial liabilities timely. To process the smooth transition of treatment and reimbursements, involve tests to make them aware of the responsibilities to pay regularly and remind them to notify the practice when changes occur in paperwork or the provided information. With this thing in practice, it will be hard for them to claim ignorance for delinquency reasons.
• Collecting and verifying patient information – Get all the information you need from the patient and verify every now and then to make sure they are accurate. This information may include name, address, email, workplace, phone number, etc. Also, do ask for a photo ID when the patient visits for the first time so the collection agencies will ensure that the bills are sent to the right person.

Verify patients’ addresses regularly to ensure that they haven’t changed the address or other information they provided.

• Ask for permission to send messages – While taking new patients on board, ask them for permission to send them messages about billing and voicemail reminders.
• Establish Payment options – Ask for the payment options and try to ease the process for the patients. Ask what medium they would like to use, whether they want to go with a credit card, cash, or checks. Also, ask if they have a payment plan from an insurer.

2.  Managing Claims Accurately

According to an estimation, 80% of the submitting medical claims contain errors. This is because of the unawareness of the changes in the billing system and the insurance companies are quite strict on the billing and claiming process. Eventually, the cycle of claiming, denying, and resubmitting takes weeks long and the practices have to wait to get paid for the services they provided.

Some of the Common Errors Include;

• Incorrect and incomplete patients information
• Incorrect and incomplete providers’ information
• Duplicate billing
• Incorrect and incomplete insurance information
• Poor and partially filled documentation
• Lack of EOB on a denied claim
• Unclear or denied codes or wrong denial reference numbers when resubmitting claims.

3.  Minimize Coding Errors

To make your claims simple to decipher, it is also a prerequisite to use standard codes. These codes are read by the CPT, ICD-10-CM, and HCPCS levels of the II classification system.

However, using the standardized codes by the medical coders, there are still some chances of errors. The most common errors include mismatched, incorrect, and missing codes. These common issues are often identified by clearinghouses before they reach the insurance party. But some issues are hard to catch such as incorrect modifiers, upcoding, undercoding, and non-specific diagnosis codes.

4.  Handle Rejected and Denied Claims Promptly

There’s a significant difference between denied and rejected claims. A claim is rejected when it is not processed further on the occurrence of the errors in the claim. A denied claim is the one that is processed but the insurance company finds the violation of the contract or some important factors that halted the process.

A rejected claim can be resubmitted by removing errors but a denied claim needs an appeal before resubmission that delays the process of reimbursements and eventually revenue cycle hurts.

Double-check the occurrence of errors before submitting the claims to avoid the lengthy method and expedite the claiming process.

5.  Look for Potential Ways to Improve

As mentioned before, the constantly changing healthcare reimbursement requirements make it challenging for physicians to maximize revenue and efficiency. In order to minimize errors and maximize efficiency, physicians need to practice these steps;

• Monitor the accounts receivable
• Stay informed and updated on the pending payments and the changes in the medical system
• Identifying the errors in the accounts

6.  Outsource When it is Needed

Medical practices should remain aware of the staff maintenance problems, changing trends in the medical industry, and patients’ preferences. Practices also need to remain updated with the current rules, policies of the insurance companies, coding standards, and billing guidelines. With many things to keep in mind, errors may occur, and detailing can slip out of mind.

Despite having the best practice in hand, physicians lack in proactively staying up to date with the current trends and the information.  And this happens when there’s a constant involvement with patients’ care, tracking down payables and receivables, submitting, editing, and resubmitting claims. And these duties are piled up to create a heap of responsibilities for the medical staff to look at.

In response to these responsibilities, many practices take the opportunity to outsource the billing and coding to medical billing services providers. For many uninformed practices, it is an easier way to enhance their revenue numbers by just outsourcing this time-consuming task.

Several benefits of outsourcing the billing process are there. Some of them are;

• Experts interventions – These medical billing services company have dedicated staff and experts in the field of billing and coding. They ensure that the claims are billed correctly, resubmitted ones are edited properly, and denied are appealed promptly. Unlike physicians, they just have billing and coding responsibilities so they are more focused on one thing which makes the work error-free.

• Fast submission – Trained individuals take less time to process and submit claims and have a greater understanding of the process.
• Up-to-date standards – These healthcare billing service providers are more informed about the medical coding laws, updates, and upgrades.
• Greater focus on patients – When a billing procedure is outsourced, the time spent previously in coding and billing can be more allocated to the provision of patient care.

Ending Note

If your practice is under strain and lacking potential revenue generation, it is high time that you should outsource the service to a medical billing provider like Clinicast. Introducing the provider into your practice will ease your burden and help you get over the hurdles of revenue management all in one.