Major Medical Billing Issues Faced by Healthcare Providers


Major Medical Billing Issues Faced By Healthcare ProvidersThe medical billing process is a relationship between the healthcare service providers and the insurance companies. This process has undergone tremendous streamlining with the coming of technology but there are still some ongoing issues which can come in the way of a smooth run towards getting paid for their services. Some of the potent issues are:

    • Getting the full payment: Often the due payments are paid either in installments or partially, citing non coverage of certain aspects in the insurance policy. This is a challenge as receiving the payment in entirety is a priority because the services have already been rendered. This issue requires strict and clear policies at the healthcare’s billing desk where the payment of full amount is defined and explained clearly. This should ensure that there are no gaps that can be used for tweaking interpretations.

  • Exhaustive knowledge of the insurance policy: There are cases when patients are not fully aware of their insurance policies. This leads to miscommunications as well as delays in getting the payments through. It is therefore imperative for the healthcare providers to go through the insurance cover and iron out ambiguities in the same along with other related information to avoid any uncalled for exchanges.
  • Taking up procedures that aren’t covered by insurance: If there is a treatment or procedure that is to be taken up necessarily but it’s expensive and is not covered by the patient’s insurance policy, it is advised that the healthcare provider informs the patient about it in advance. All the insurance policies and companies are different and have their own rules. It is therefore important to be informed of exactly what is covered and what is not under the scheme.
  • Staying up to date with coding: Medical practitioners need to stay abreast with the latest codes and sub codes so that the payment and claims process is simple and hassle free.

Once you have outsourced your billing management to, you can be assured that impediments like those stated above are ironed out. We bring in professionalism and unmatched expertise in ensuring maximum revenues to a hospital that has provided its services to its patients.

This entry was posted in Accounts Receivables, Medical Billing, Revenue Cycle Management (RCM). Bookmark the permalink.


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