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The healthcare industry is dynamic and constantly changes. Medical practitioners need to stay on top to prevent any revenue losses for their business and must keep themselves aware of any amendments in billing regulations.

Independent medical practices miss the opportunity to gain 30% potential revenue because of an inefficient billing and collection procedure. The main reason for this is the high rejection and denial rate. A large number of denials can lead to the revenue being locked in accounts receivable which can result in an inefficient cash flow.

Medical Billing Strategy

Medical practitioners should develop a strategic plan to organize their responsibilities. The best approach for this is to form a detailed plan, outlining and providing information for every step of the procedure.

  • The billing method can be thoroughly tracked through this and shortcomings can be identified and improved at every step.
  • The revenue cycle management can be upgraded by increasing authenticity, and patient satisfaction and provider-payer relationship can also be enhanced.
  • This is achieved by making sure that all parties To save time, a proper claims management process should be developed.
  • Claims should be verified to monitor any errors before they are submitted.

Through this, practices can successfully reimburse their claims. provided with accurate bills.

Claim Process

Around 80% of medical bills have errors, which causes denial or rejection because of insurance payer’s policies. Although they can be resubmitted, this whole process is very time-consuming.

To save time, a proper claims management process should be developed like:

  • Billing software can be used to ensure that accurate claims are filed.
  • Equipment and resources can also be used to track paid and unpaid claims.
  • Claims should be verified to monitor any errors before they are submitted.

These practices can successfully reimburse claims.

Coding Errors

In Healthcare Revenue Cycle Management, Correct medical coding is a very important step. Accurate coding prevents claim denials and rejections.

  • Cases should be coded by certified medical coders.
  • Non-specific diagnosis codes should not be used.
  • Rejection and denials can take place to employ the classification codes which are less specific instead of the ICD-10 which are more detailed.
  • In the case of incorrect modifiers, claims can end up in rejection. A charge reconciliation process should be employed to prevent charge leakage.

Clean Claims

Scrubbing in the claim preparation process is the main part. The key aim of the claim scrubbing is to find errors that are left during the clam preparation process. If these errors are detected right before the claim submission it saves lots of time and energies which is required to fix it afterward. Some medical billing services providers use third-party claim scrubbing and also takes help from clearinghouses.

Quick follow-ups

It is not like that you prepared a good payment claim and then forget to ask the payer about the status of the payment.

The timely follow-ups and inquiring the insurance companies about the status can speed up the process. In this way, you can easily find if a claim is denied due to some errors in it, and through timely correspondence the claim acceptance rate increases. This is the reason most medical billing companies have a well-planned follow-up process that helps to close the billing loop well in time.

Denial Management

A productive denial management system is essential in establishing a healthy cash flow.

  • Denials should be worked within 2 days of being received and during insurance follow-up, they should be the priority.
  • A comprehensive list of claim adjustment reason codes (CARC) should be developed, and similar follow-up actions should categorize them.
  • Preventative denial analysis should be conducted to identify the root cause to decrease the denial rate in the future.

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Revenue Cycle Management

RCM services should be used to adapt to the dynamic healthcare field.

  • Performance can be monitored and the latest rules and regulations should be followed to identify errors and introduce strategies to manage the problems,
  • To determine the fine bills, aging accounts receivables should be monitored.
  • Stay up to date with billing rules and modify your procedures accordingly.
  • A billing solution should be employed to manage accounts and to track potential problems and errors.
  • Key identifiers can be utilized to counter issues such as late payments, changing contact information, or declined

Outsourcing

Managing to bill in-house makes it difficult to stay up to date with the recent coding and medical billing rules, federal regulations, and insurance companies. This may increase rejections, leading to profit losses for the business.

Expert medical billing service providers should be consulted if the business is facing problems with collection management. They do have experience as well as the resources to manage the accounts receivables for the business and improve its financial health.

The practices which neglect to bill and only keep their focus on the care delivery process can lose a significant part of their revenues. A well-planned billing process helps to increase the collection of medical practices.

Get a free no sting attached billing services quote from ZEE Medical Billing for your practice.