Efficient Medical Billing: 10 Easy Steps You Must KnowMed Miles LLC
Medical billing is followed by the procedure in which the service providers maintain and submit the records of the patient to the insurance companies to submit a claim to get paid for the services they provided to the patient.
When it comes to the efficient billing process some steps are crucial for a successful reimbursement from the insurance companies. Otherwise, the practice of medical billing is so long and it takes weeks or even years if not done effectively.
Here are 7 easy steps which you must know for efficient Medical billing
Steps For Efficient Medical Billing
1. Keep The Record of The Patient
The very first step of medical billing is when the patient takes the appointment for the doctor visit, the whole process is recorded which includes his personal information like his name, address, city, and the details of his insurance providers. These records are essential for further assessment.
By taking all the records now you can easily estimate the medication and treatment process his insurance companies are willing to pay for because certain insurance companies are not willing to pay for certain treatment processes and most of the time the patient is unaware of it, so a timely discussion with the patient can help in reducing the negative outcomes in the future.
2. Trained Your Staff Members
The training of your billing staff is the essential step for a successful claim, As there are many insurance companies and each company has different sets of rules and regulations. There are possibilities of errors from the staff members like coding errors, late claim submission, and any kind of mismanagement that results in delay or cancellation of the payment.
To meet all the set criteria the staff members who handle the revenue cycle must have some extraordinary skills. So an effective training program is very crucial for efficient working with less chance of errors.
3. Choosing The Right Vendor & Software
Choosing the right vendor for your software can help you with the efficient billing process. A software vendor can understand the requirements and expectations of your work. Make sure that you can establish a platform that can integrate with all other Softwares of your system.
Proper training of your staff members is also very crucial in using the software system. Moreover, vendor support is also necessary to develop a proper software system for the billing process.
Using technology is the best way to make the billing process more efficient for you. If the technology is available for the process like filling the claims, generating and issuing the payment reminders then it is better to take away these tasks from the staff members because manually doing these tasks may consume lots of energy and time which may be utilized with other patient-centric services.
5. Proper Medical Coding
Most of the insurance companies used the codes which are specified by the American Medical Association, these codes are mainly CPT or HCPCS., All these codes are used by the coding specialist who modifies the details and treatment delivered by the service provider to the patient during his stay in the hospital in the form of codes after that these codes sent to the insurance companies who then released the amount after proper assessment. The typical information included in the codes are;
The reason for the visit to the hospital and What kind of disease is diagnosed and the possible treatment.
6. Submitting Claims
Once all the essential information gathers in the form of codes, then the next step is to submit this to the insurance company to claim reimbursement.
These claims are submitted through Electronic Data Transfer ( EDI) The information is verified by the third-party vendor and after that, the insurance company also verifies the information and if they find any errors and misinformation then the claim is rejected or returned to the health care service provider.
7. Track Denial Rates
For better revenue cycle management, it is necessary to reduce the denial rates as much as possible, there might be various reasons behind the denial rates, sometimes it occurs due to coding errors and maybe the mismanagement of claim submission by the staff member like late claim submission because insurance companies only approve the claims which are submitted on time. Another reason might be the follow-up of a pre-existing claim.
Consistent denial rates are the indication of improving the gaps in the revenue cycle management. For an efficient medical billing process, the denial rates must be as low as possible.
8. Track Delinquent Claims
Any claim that is unpaid for more than 30 days after its submission is considered a delinquent claim. Tracking your delinquent claim increases the efficiency of your revenue cycle.
There should be a team of dedicated staff members, whose primary concerns are to monitor the delinquent claims. Most probably Delinquent claims occur due to the communications issues between the service providers and the insurance companies, you can estimate it by reviewing some aged accounts receivables.
9. Maintain Good Quality
Maintaining a good quality in the billing process enhances your chances of low denial rates with maximum revenue. For this purpose, you can check the account balance accuracy by creating a deposit log. This will ensure the smooth flow of information towards the reviewer.
10. Outsourcing The Most Difficult Tasks
Outsourcing is the way that can improve revenue cycle management of health care service providers.
If you are too facing problems in the billing process, then you should outsource the billing team, which assures maximum revenue with low denial rates.
As most of the health service providers are lagging in managing their billing process, constantly receiving denial which is very stressful and also impacts the smooth flow of the revenue cycle.
If you need a team of professionals to handle your billing activity then Med-miles have experience of more than 8 years in dealing with medical billing services.
Our main goal is to serve our clients with the best revenue cycle solutions, Our main focus is on denial management and getting maximum reimbursement. You can call us at (888) 598-9181 for further information.