Approximately $125 billion is estimated as the uncollected revenue each year for the US healthcare industry. The financial health of the medical industry is weakening due to inefficient medical billing and coding processes. There is a need to take extraordinary steps to mitigate the inefficiency in medical services. For this reason, the physicians can focus on the following aspects to generate exceptional medical billing services.
- Minimize the billing and coding errors
It is imperative to minimize the coding and billing mistakes while filing the claims as a medical billing specialist. Such errors can cause the provider and the health center loss of hundreds of thousands of dollars. However, the medical providers can generate massive profits through efficient processing of successful claims. Therefore, a little mistake can cost a fortune. The medical billing expert can eliminate the coding and billing errors with the help of following tips:
- Review the billing and coding error to fix them.
- Train the staff and make sure that they are aware of the frequent updates.
- Create an open communication between the medical professional and the team.
- Report and evaluate the errors on a monthly basis.
- Effective Collection Process
Cash flow is the primary motive of every business. Medical care centers do not fall in an exception. In 2018, a continuous trend of failing to pay co-payments and deductibles by the patients is noticed. A challenging economy and higher inflation rates are also seen this year. Eventually, the cash flow of the medical centers is at risk. The billing and coding services can be made efficient by adopting the following suggestions:
- Trained staff is necessary to establish a proper collection system.
- The charges of the treatment and health care service should be made apparent.
- Make the payment process more accessible.
- Make a contract with a medical billing service provider.
- Proper claims follow-up
Around 80% of all the medical bills contain errors because the medical billing and coding practices are strict nowadays. The process of submission, rejection, editing, and resubmission takes weeks. The medical providers have to wait for several months sometimes to be paid for their services. While managing the claims, the billing and coding specialists should avoid the below-mentioned errors.
- Incorrect Patient data and info
- False physician information
- Wrong insurance information
- Copied billing and coding
- Poor documentation
- Missing or unclear denial codes or claim number references on a denied claim.
If the claims are managed as per the criteria mentioned above, the billing and coding problems can be reduced significantly. The specialists can also double check the claims for good results. They can also contact the provider if any information is omitted.
- Prompt action on denials or rejected claim
Immediate action should be taken by the specialist to avoid the denials or rejection of claims. The denied claims can be corrected, but only an appeal can be made against a rejected claim. It is a costly and time-consuming procedure. If you keep checking the claims before submitting them, then errors can be minimized. If any of your claims are denied or rejected, you must take prompt action. Also, make proper contact with the representative of the payer. It will end up helping you to speed up the claim editing process and reducing the appeal and resubmission times.