5 Proven Patient Billing Tips from the Top Medical Billing Companies

Medical clinics, health centers and even hospitals frequently struggle with optimizing the patient billing process and account resolution. Medical billing affects the revenue cycle and it is a constant challenge for even the best-run medical practices and hospitals.medical billing optimization

It is incumbent on these institutions to utilize technology,for example using the appropriate bill management software, so as to fastidiously track each claim at every stage, and also promptly address any emerging problems. This will lead to healthy cash flows and predictable revenue streams.

Proper management of the revenue cycle is heavily dependent on robust and clear communication flow. Other crucial tasks in proper management of the revenue cycle include thoroughly ascertaining the insurance status of the patient, precise coding of claims and collecting co-payments. The following are five tips for streamlining and optimizing medical billing in health centers and medical clinics.

1. Improving the percentage of clean claims should be a perpetual objective

Grappling with denied and rejected claims consumes employee time and reduces cash flow. Therefore attaining high rates of clean claims should be a cornerstone of revenue cycle management for the health center or medical clinic.

As suggested by most professional medical billing companies, follow-up of claims should mostly be done electronically using proper software to make it speedier and optimized. A clean claims rate that is high not only ensures a healthy cash flow but it can also save substantial amount money each year in costs of paperwork, time used up communicating with insurers and recalculating claims.

2. Cross-training personnel and clarifying roles

Every person involved in the revenue cycle must know how their job feeds into the revenue realization process of the health center. Clear, intelligently-designed workflows are vital in getting each person to understand how they fit in this process.

Cross training is critical to ensure operations are smooth during employee absences or when challenges emerge such as the change-over from ICD-9 to ICD-10 coding. Investing in training translates into savings in the long-term.

3. Designing an authorization checklist for insurance

The better the system of analyzing patient eligibility and regular upfront pre-authorization, the smoother the billing cycle will operate until patient discharge and account payment. It is advisable to give the admission personnel an insurance authorization checklist during patient registration.

Understanding eligibility from the outset helps both the health center and the patient who can be given estimates of their out-of-pocket obligations. Such a checklist at the admission point can help ensure that no steps in the preauthorization process are overlooked. The patient’s social security number should also be obtained to help speed up processing insurance claims and better maximize revenue for medical billing.

4. Determining the claims metrics to concentrate on

It can be very beneficial to track and analyze the right metrics. Monitoring claim denials and rejections can help pinpoint patterns and sort out the underlying sources of problems.

Included in this analysis should be a regular review of the time duration in days that any denials delay the payment process. The number of appeals for each denial should be progressively reduced. Using an electronic system with analysis software can help resolve queries in larger claims by data mining any electronic attachments.

5. Patient education is of paramount importance

Patients know they will get billed and when the health center assists them to understand each step of the process, this can greatly improve bill settlement. Patient education helps them know the financial implications of their account balances and what options they have in meeting their obligations.

Advising patients with low income about coverage through external parties such as Medicaid should be done prior to admission. The same applies to any options of making installment payments.

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