Maximize Revenue for Your Medical Practice: Medical Billing and Coding Tips

With healthcare costs averaging 10% of the average family’s budget, some people spend much more per year. If you’re running an office, clear medical billing practices with a high degree of accuracy keep patients happy and keep you in the clear. When you want to maximize revenue, you need to keep your system running smoothly.

Here are four ways to ensure that you get the most out of your medical billing.

1. Make Your Collections Crystal Clear

If you want your practice to survive, you have to have a clear and simple way to collect the funds that you’re owed. When everyone on your staff understands how the system works, you’ll ensure that everyone processes their payments quickly. If you want to improve revenue cycles, this is the way to do it.

Start by informing every patient what’s expected of them and when they have to settle their payments. You need to write in plain language what the have to and by when. When you sign them up as a new patient for the first time, this should be clear to them in every way possible.

Don’t forget to get all of their information and to verify addresses. Some people change their addresses or contact information so ask them every time they visit your office. When you speak with them, get their consent for contacting and leaving messages.

This ensures that you can contact them about test results or about any missing payment that you’re owed.

There are usually co-pays involved so have a clear set up for this. Everyone should know what’s expected of them when they get their care from their doctor. Give a variety of payment options so that no one has an excuse that they don’t have the method you’re looking for.

2. Have a Strong Claims Management System

So many medical bills have errors that it’s tough to count. With so many problems on the billing side, it’s no wonder that offices have trouble getting paid either by insurance companies or by their patients. If someone sees something on their bill that they didn’t have done or if you fail to make the right claim on their bill, you’ll lose out on money.

Editing and resubmitting claims costs you time and money. You need to have a method in place for ensuring that everything is done correctly the first time. Double-checking every claim is a pain in the neck but nowhere near as much of a pain as not getting the money you’re owed.

Commonly, people forget to add the right information about a patient. The wrong date of birth or insurance ID number could lead to the wrong person getting charged. If you don’t have the right insurance provider information, the claim might never reach the right people.

If you document things poorly after a procedure, it’ll be much more difficult to make the claim. The insurance company or the patient might raise a red flag and think that the claim is false. The biller can contact the provider if more information is needed.

Some insurers still need to see a physical claim in pen and ink. If the explanation of benefits isn’t attached to the claim, then it’s going to be harder to find the error. If the codes used are unclear to the insurer, that could spell trouble for an office trying to get paid.

3. Fix Coding Errors

With the help of medical codes, insurance companies and medical offices ensure that they’re speaking the same language. This makes claims easier to process and helps everyone decipher what really happened with a claim.

These codes rely on ICD-10-CM, CPT and HCPCS Level II classification systems to communicate. This standardization helps to avoid errors, but some errors are inevitable. Mismatched, duplicate, or incorrect codes can still result in problems when you’re trying to make your claims quickly and efficiently.

There are a few unspecific diagnosis codes that lead people to become confused. Because there are such stringent requirements for some procedures to be covered, the presence of these can cause serious roadblocks. If the practitioner hasn’t documented the patient’s condition before or updated regularly, some things that should be covered aren’t.

Your team has to be careful about upcoding, where certain codes for more expensive procedures are exchanged for lower value ones. There’s also the case of undercoding where expensive procedures are left out. This is sometimes intentional but sometimes accidental.

4. Outsource if Necessary

While most medical practices want to retain complete control over their billing process, there are times when it’s just not feasible. When practices are worried about patients, medical trends, and their staff, it’s hard to focus on the thing that brings in the revenue. It might seem odd, but most medical facilities are too busy to worry about billing.

Rather than overextending to implement proactive billing practices, things could be outsourced to a company that knows what they’re doing. They can submit and edit claims on behalf of the medical facility to ensure that revenue keeps pouring in. All the while, the office can continue to provide great care to every one of its patients.

When you hire dedicated specialists, you have people who know medical coding like the back of their hands. You also have people dedicated to the filing and submission process. Rather than having them paid like regular staff, you pay for their services more or less a la carte.

This helps you save money while focusing on your patients. If you want to know what you could be tasking them with, click here to find out more.

Maximize Revenue By Eliminating Mistakes

If you want to maximize revenue at your medical facility, your best bet is to clear out as many mistakes as possible. With the right training or the perfect outsourced staff, you get everything you need to keep providing great quality care to your patients.

To make better decisions for your business this year, check out our guide for tips.

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