Medical Billing Issues That are Affecting Your Practice Revenue

Billing and revenue cycle management are the backbone of any medical practice, yet they are also the bane of most practice owners’ existence. Billing and coding require countless hours, tedious computer work and ongoing education. As a result, it also requires a lot of resources (i.e. money). For this reason, it’s important that claims are filled out and filed correctly the first time around. Unfortunately, because of how tedious billing is, it is not uncommon for claims to contain errors. Errors can result in denial and set back claims by months. In the worst-case scenarios, errors can result in claims of fraud. Fortunately, there is a way to avoid these types of errors and ensure accurate billing almost 100 percent of the time: medical billing outsourcing.

Capture All of the Right Patient Information 

One of the main reasons that claims are denied is because of inaccurate or incomplete patient information. Even errors as small and seemingly inconsequential as a misspelling in a patient’s street address can result in a denial notice. Your personnel should be collecting patient information at the very first point of contact, which is the initial phone call. Office staff should then verify the information and collect more via forms and face-to-face conversation when the patient arrives for his or her appointment. This type of interaction lays the foundation for billing.

It’s not only essential that your front-end staff collect patients’ basic information, but also, they need to collect and verify patients’ insurance information. Another main reason that claims are denied is because of eligibility issues. Eligibility issues account for nearly 10 percent of denial rates. A professional medical billing consultant can help you avoid these issues and ensure accurate filing the first time around.

Inform Patients of Financial Responsibility 

More insurance plans are reverting to higher deductibles and lower premiums, which is great for consumers but not so great for medical offices. Most consumers are not aware of the magnitude of their financial responsibility, which has the unfortunate result of making it harder for offices to collect for services rendered. You could negate this issue by working with a medical billing company.

Medical billing outsourcing specialists have policies in place that make it easier for patients to pay for services rendered in timely fashions. They also have enforcement policies in place that ensure if a patient is late in payment, he or she is made aware of it. Though the solution seems simple enough, it can go a long way toward improving revenues and cutting back on non-payments.

Cut Back on Inaccurate Coding Errors 

Another reason that many claims are denied is because of inaccurate coding. This happens for a couple of different reasons. On the one hand, codes are always changing, so even the most educated coders often make errors unwittingly. On the other hand, coding involves inputting several strings of numbers over and over and over again. It’s inevitable that a mistake will occur somewhere along the way.

Coding software is designed to update whenever there’s a coding update. It is also designed to spot inaccurate or suspicious codes and revise them to fit with the proper procedure. This software does the best job of reducing billing errors and of increasing practice revenue. Want a second set of eyes, contact us today and we’d be happy to help!