The success and revenue of any organization depend on the number of components but the most important is finance. Lag days play a critical role in streamlining the flow of your revenue. Most people hear the term lag days for the first time and are unaware of it but this term is important for healthcare organizations because all the financial components depend on the period in which the services are rendered and when the claim is submitted for this service.
Zee Medical Billing has been providing medical billing services for more than 20 years, so it is excellent to provide helpful guidance on how to minimize lag days and maintain ideal streams of revenue. Let’s examine this concept in more detail and look at the six important suggestions proposed by Zee Medical Billing.
What are lag days?
Before proceeding to the tips let’s first see what are the lag days so that people get aware of it.
Lag days, also called charged lag, consist of the period between the patient visit on which day the service is rendered and the initial submission of a claim. Lag days help healthcare organizations speed up their claim collections and claim submissions. If the claim is submitted after the deadline it can result in loss of revenue. Higher lag times can also slow down the rate at which patient balances are collected, which makes processes more difficult financially for medical businesses. Organizations can enhance cash flow, minimize revenue losses, and streamline their revenue cycle processes by reducing lag days.
Lowering lag days is essentially about protecting healthcare organizations’ financial stability, increasing patient satisfaction through an accelerated reimbursement process, and optimizing operational efficiency.
6 steps to Reduce the Lag Days
Tip 1: Measure Lag Days
The first step that ZEE Medical Billing suggests to you to reduce lag days is to accurately measure them. Healthcare providers can obtain information about the time lag between service delivery and claim filing by employing comprehensive analytics and reporting technologies. This information is used as a starting point to identify problematic areas and put focused improvement plans into action. The majority of the time, the charging lag is mostly caused by a few major problems. Several elements need to be considered to determine lag days accurately:
- Location (Clinic): The billing process can be affected by the place where the service was rendered. Reducing lag days requires ensuring efficiency and consistency across all clinic sites.
- Date of Service (DOS): It’s important to quickly record services provided and submit claims for them. Billing delays can result from failing to record the date of service on time.
- CPT Or Procedure Code: Accurate billing requires proper procedural coding. Procedure code errors or inconsistencies can result in claim denials or rejections, which can cause delays in reimbursement.
- Rendering Provider: The billing process has to accurately identify and record the provider that performed the service. Billing delays can arise from any errors or discrepancies in provider data.
- Reputable Payer: It is crucial to understand who is responsible for paying for the services provided. It is necessary to pay close attention to details in order to prevent delays because different payers may have different criteria and processes.
- Rejection Reason: Monitoring rejection reasons from clearinghouses or practice management systems can identify important areas in need of development. To reduce billing delays, it is possible to implement specific strategies by identifying common causes for rejection.
Step 2: Identify Causes of Charge Lag
Zee Medical Billing highlights the need to identify the specific causes of charge lag after gaining deep knowledge about the changing nature of lag days. Our primary recommendation is to identify the underlying reasons to properly implement targeted solutions. Charge delays in medical billing processes are frequently caused by incomplete documentation, inefficient billing practices, and delayed claim submissions. Healthcare companies can streamline revenue cycle management and improve processes by identifying and addressing these common issues.
Step 3 – Adjust Practice Management Systems & Business Processes
It’s time to take action now. This crucial phase requires the participation of people who are knowledgeable about the systems and business processes to create a thorough plan for resolving the main reasons for charge delays. An emphasis on efficiency and long-term sustainability is crucial while addressing this issue, even if certain solutions, such as making sure a National Provider Identifier (NPI) is recorded in practice management systems, might be simple to implement.
- Determine the Causes: Start by determining the underlying reasons for charge lag, giving top priority to those that have the most influence on delayed billing. This includes examining current procedures, conducting staff interviews, and evaluating data from practice management systems.
- Formulate a Plan: After determining the underlying causes of each issue, create a strategy to address each one in turn. Assign tasks to the people or groups in charge of putting the suggested solutions into practice, making sure there is clear responsibility and a deadline for completion.
- Address Systemic Problems: Resolve systematic problems in practice management systems that cause billing delays. To avoid rejections, for instance, make sure that all required data fields—like NPI—are regularly entered and checked. Establish systems to track and notify accountable parties of inaccurate or missing data, enabling timely resolution.
Step 4: Harness Technological Potentials
Technology is essential to the claim submission process and improves each step’s overall effectiveness. ZEE Medical Billing thinks that Practice management software and electronic health records (EHR) are essential assets that streamline claim submissions and transform several other processes in healthcare organizations.
- Electronic Health Record (EHR) Integration: A system for electronic health records integrated into the workflow can greatly improve the speed at which claims are submitted. By enabling healthcare providers to digitally record patient data, diagnoses, treatments, and other relevant data in a consolidated system, EHRs simplify the documentation process. This provides a smooth connection with billing systems for effective claim generation and submission, in addition to improving the quality and completeness of documentation.
- Practice Management Software (PMS) Utilization: Practice management software provides complete solutions for managing the appointment scheduling, visit documentation, and patient record-keeping processes of healthcare offices. Healthcare companies can enhance overall operational efficiency, minimize manual mistakes, and streamline administrative tasks by utilizing PMS. Furthermore, PMS helps minimize claim denials caused by inaccuracies or redundant information by helping to maintain critical patient data, including insurance status and billing information, updated in real time.
- Error Prevention and Claim Denial Avoidance: Healthcare providers can maintain accurate and current documentation by using EHR and PMS systems, which lowers the possibility of errors that could result in claim denials. These systems’ integrated validation checks and automated procedures enable them to recognize and highlight possible inconsistencies or mistakes in documentation, enabling quick correction before claim submission. Healthcare companies can reduce the likelihood of claim denials and guarantee timely reimbursement for provided services by taking proactive measures to rectify paperwork mistakes.
Step 5: Follow Up on Denied Claims
Healthcare practices frequently experience claim denials; however, effective practices stand out for taking a proactive stance in resolving these denials. Surprisingly, research indicates that as many as 50% of rejected claims are never investigated again, resulting in large financial losses. Medical billing staff need to make following up on denied claims a top priority and take proactive steps to resolve them to minimize losses and maximize reimbursement. To manage the follow-up on rejected claims, take the following actions:
- Reexamination of Denied Claims: Medical billing employees must quickly review denials of claims to determine the underlying reasons for the denial. Claims that contain submission errors—such as inaccurate patient information, invalid procedure codes, or missing documentation—are frequently rejected by payers. Therefore, thoroughly review the rejected claims to identify the cause.
- Setting Resolution as a Priority: Prioritizing the resolution of refused claims is crucial after the reasons for denial have been found. Proactive follow-up actions can include correcting errors in the claim submission, providing additional documentation or information requested by the payer, or appealing the denial if necessary.
Step 6: Build an Efficient Team
Last, but not least! Zee Medical Billing prioritizes having a skilled and knowledgeable team of medical billing professionals in order to streamline the billing process and guarantee timely reimbursement. We pay attention to it since we are aware that having skilled employees not only increases productivity but also reduces difficulties while submitting claims. What important role can an effective team play in reducing the number of lag days? Let’s examine:
- Medical Billing Specialists: Skilled medical billing professionals are extremely useful because they can easily navigate the complexity of payer rules, coding standards, and billing restrictions. Their expertise in using EHRs and other software programs allows clinical and administrative procedures to be integrated seamlessly, which makes accurate documentation and timely claim filings possible.
- Employees at the front desk: Employees working at the front desk are essential to making sure that patient demographics and insurance information are accurately recorded. They reduce the possibility of billing problems and provide the groundwork for successful claim submissions by carefully gathering this data during patient registration. Additionally, front desk employees may help with insurance updates and advance patient debt collections, including coinsurance and deductibles.
- Collaboration and Communication: To optimize processes and proactively handle difficulties, team members must collaborate and communicate effectively. Team members can exchange information and build their skills through regular training sessions and cross-functional meetings, which also help them remain up to date on industry trends and best practices.
- Ongoing Education and Training: Investing money into ongoing programs for training and development guarantees that team members stay current on changing laws, technological advancements, and industry norms. Healthcare practices enable their team members to thrive in their professions and successfully adjust to changing requirements by offering chances for professional development and continuous education.
Frequently Asked Questions
Lag days, also known as charged lag, refer to the period between a patient’s visit, when services are rendered, and the initial submission of the claim for reimbursement.
Lag days play a crucial role in accelerating claim collections and submissions, ensuring prompt reimbursement, and maintaining steady cash flow for healthcare organizations.
Zee Medical Billing offers six crucial steps for reducing lag days, including implementing automated billing systems, ensuring accurate documentation, verifying insurance information, streamlining claim submission, monitoring claim rejections and denials, and building an efficient team.
Reducing lag days can lead to faster claim collections, prompt reimbursement, improved cash flow, and enhanced financial stability for healthcare practices. It also facilitates a smoother patient billing experience and minimizes revenue losses.
Healthcare organizations can measure lag days by utilizing analytics and reporting tools to track the duration between service provision and claim submission, allowing them to identify areas for improvement and implement targeted strategies.
