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Saturday, April 20, 2024

Upgrade Your RCM Integrating With Medical Billing Services

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Billing and data management still remains as sore challenges to the clinician due to the complexities of the process. But being the most integral part of the revenue cycle it sure cannot be neglected. Optimizing this process is hard work, very demanding and takes up a lot of time and revenue, which is why outsourcing to medical billing services is in good order. There should be effective coordination between every department of the facility to facilitate faster billing process, so that payment is received without delays.

In this article let us look at some of the challenges encountered with billing process and how billing service providers can help you rectify them.

Gaps in information capture

Billing process normally starts from the very first contact between patient and the facility. There are a lot of things the front – end staff of the clinic can tackle at this stage. Information collected at this level furnish the initial ground work to payment collection. Which is why the staff cannot afford to fail in accurate data collection.

There is capture of patient demographics to be done without errors and fed into the providers billing system, along with verification of their insurance status. Every detail of the patient’s insurance plan should be looked in to because, many at times eligibility issues are the key problems behind claims getting rejected. The specifics of the package the patient is subscribed need to be checked and rechecked so that neither you or the patient will have to deal with unexpected surprises of noncoverage after treatment.

Insurance companies keep revising their packages, so it is crucial to verify the current status of the coverage plan at every visit not just the first time.  Medical billing services take the preauthorization of claims very seriously to avoid confusions while claim processing. Also, verification of policy number, type of policy, validity and expiry needs to be captured. To meet the demand of this process, your staff should be duly trained.

Failing to educate the patient on payment labilities

Making the patient well aware on how the payment is broken down between them and the insurance payer is very crucial to obtain full payment for the service rendered. Gives them an idea on how much they owe the facility after receiving reimbursement from the payer. Billing services have come up with comprehensive invoice systems which shows the patient every detail regarding billing.

Instead of mailing complex billing documents from each speciality separately after receiving treatment, the new consolidated bills are easy to comprehend and patient friendly. With the provision of patient portals, they can easily look at their lab reports, treatment process and division of payment. Billing service has support teams which assist the patient to go through the particulars of the bill for clarity and better understanding of their financial responsibility to the facility. This way the patient, payor and healthcare provider can communicate and coordinate better about their roles.

Coding errors contributing to claim denials

Any day, errors with coding process remains the most common and most important factor deciding the efficiency of your revenue cycle. Getting the codes right for the procedure and diagnosis is still a challenge for new practices as well as matured ones. It takes a lot of talent and practice from the part of the coder to get the coding perfect.

Adhering to constantly revised coding regulations requires frequent training sessions and back up from the versatile coding software’s.  Coding compliance is strictly maintained at professional billing services.

Technological interventions on claim processing

Processing claims manually is very much outdated since the insurance payers have already levelled up their process to electronic channels. The expectation is to receive comprehensive electronically submitted claims. The providers are quickly adopting data – based value driven models of claim processing solutions by medical billing servicesas it has become the need of the hour. It provides a wonderful interface for communication between the front- end and back – end staff.

Every claim goes through an audit and clean scrubbing before getting submitted. Considering the strenuous labour associated with processing claims, having to work on it again after facing a denial can be quite frustrating. Getting the claim error proof in the first go is the best way to take care of this. It makes a huge difference to the revenue cycle. Every day brought down from the time span of patient visit and full payment on account receival pertains to a faster revenue cycle and has its perks on your profitability. Opportunities are tremendous with automated billing solutions regarding denial management as well. Spotting the root cause, applying modifiers and revision of the claim is easier and faster than before.

Health care providers claim major reduction in write offs after implementing medical billing services at their facility. Everything and everyone are accountable for their roles in an automated set up. Each entry in the data base can be processed in multiple ways to present you with beautiful statistics diagrams. Going by the key performance indicator elicited from the software, you have the advantage of optimizing your revenue cycle for faster growth.


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