The hallmark of a sustainable business is an unceasing cash flow and the healthcare industry is no different. The challenging and everchanging healthcare system of the U.S. has prompted the U.S. citizens to become more vigilant and hesitant to clear up their medical dues. This problem has significantly lessened the cash influx received by the doctors. If this problem isn’t dealt with sooner, then it could put the earnings of medical practitioners in jeopardy. Failure to keep up with the collections can also adversely affect the effectiveness and efficiency of the employees associated with the practice. It could put them in a wave of uncertainty with no assurance of being payed on time.

By now we hope the repercussions of not collecting copays are evident, so in this article we will be bringing some ways through which revenue collection can be streamlined in the limelight.

1.Create an unambiguous strategy for the collection process

Prior to adopting any other strategy, it is crucial for you to establish a comprehensible collection process that you and your staff follow to streamline matters. Creating a step-by-step technique will help sustain the financial health of the firm. From patients to doctors, design an approach which is relevant for everyone involved in the billing process.

This in turn will help improve your cash flow significantly and it will also inform your staff and patients of what is expected of them and help remind them their responsibilities.

2.Start off by training your staff

Staff training is the key to unlock the influx of maximum revenue. We suggest you to come up with a billing collection strategy and then communicate it to your staff through extensive training and communication. Lead by example and carry out the practices that you want your staff to reflect. This essential training will embed the important techniques in your staff’s personalities and you will have much efficient employees at hand.

It will additionally help you eradicate ambiguity that your employees may have and ensure that ignorance doesn’t become a reason for their negligence.

3.Deal with claims vigilantly

Statistics show that approximately 75% of the medical claims are incorrect. And considering how vigilant insurance companies are about bills and payments, it is more than likely that the bill will get rejected if it has any sort of errors.

Going through the process of editing and resending claims is an onerous one and it will extend your claim payment even more, which is why, it is highly advisable to you to be extra-cautious while sending claims in the first place to avoid any sorts of problems later on.

Below we have listed a couple of areas which are usually the source of errors so be extra careful while filling these out:

  • Patient’s personal information: Full name, DOB, Insurance number, etc.
  • Provider details: Name, phone number, address, etc.
  • Insurance details: Insurance ID, policy number, etc.
  • Incomplete information: When the biller submits incomplete information about the claim, make sure to get in touch with him and get complete details to keep the claim from getting rejected.

So basically, double check your claims before you send them in order to avoid getting rejected and extending the collection period. Once you have submitted the bill, it is advisable to converse with the rendering provider and inquire whether any information is incomplete, ambiguous or missing.

4.Write codes properly

There are codes, within a medical bill to simplify the process of deciphering the claim. However, the codes are broad, which is why, attention to detail while writing them should be given otherwise coding errors can occur.

Below are some common errors that you can avoid by being more careful around them:

  • Non-specific diagnosis codes: One of the problems that exist with these codes is that there aren’t enough of them to describe all medical conditions. Often times information which a practitioner doesn’t even obtain is needed to work with these codes. This problem can be dealt with by acquiring enough information by the patient when he fills out the initial form.
  • Wrong modifier: The most common reason for unrequited claim in adding an incorrect modifier. In such claims either the modifier which is added is wrong or the modifier was missing altogether.

5.Swiftly deal with denied or rejected claims

For you to comprehend this point, we believe it’s important to initially explain the difference between a rejected claim and a denied claim.

A rejected claim is basically a bill that hasn’t yet gone through the processing stage because it has either incomplete information or incorrect details. So, in turn, it is keeping the insurance provider from paying up due to negligence. However, a denied claim is a claim that has been rejected after it has undergone processing. Due to unmet requirements or violation of rules the bill is deemed unpayable. Either way the bill will be resent to the biller with an explanation of why it was returned. While resubmitting a rejected claim, be meticulous so that it doesn’t get rejected again and read the comments carefully. However, for a denied claim you need to send an appeal prior to resubmitting it.

To save time, promptly handle the denied or rejected claims and consult with a payer representative if you have any confusions. They will help you out in clarifying any issues that you may have. This will help speed up the process of resubmission.

6.Know when to outsource

Upcoming medical techniques, latest trends, patients, staffing, medical practitioners have a lot on their plate. With so many important things which are meant to be juggled consecutively, it is easy to miss out on some minor but crucial details resulting in delayed or rejected payments. From the above points, we hope we have established how meticulous you have to be while filing a payment. However, with so many things going on, it is best to outsource medical billing to ensure growth, competency and efficiency.

Not only will it take a huge burden off your shoulders, your revenue will increase by a tenfold. Most medical practitioners swear by billing agencies and claim they can’t do without them.

Final Words:

Sending out medical claims is an onerous task to the say the least. However, if you follow the above mentioned tips, we believe you can make it ten times easier.


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