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Adopting a Multi-Tiered Appeal Process to Improve Revenue in Your Medical Practice

March 12, 2014



The medical billing and coding process is constantly evolving and newer codes are introduced every day. It is very important for your medical practice to constantly adapt to these changes in their billing and coding systems. The Revenue Cycle Management (RCM) is the basis of any financially sound medical practice and a well satisfied patient base, amiable relations between staff and patients and well trained staff members are essential for increasing revenue in your medical practice. The revenue of your medical practice can be improved by adopting a multi- tiered process that works across all areas of your practice. Increased revenue can be achieved by the following –

  • Implementation of Revenue Cycle Management – The process of revenue generation starts with the registration of a patient at your medical practice. The patient information must be up to date with all insurance details as well as copies of the insurance cards. The forms must be checked for errors and incomplete forms. The prior – authorization if required must be checked and completed. Maintenance of Proper medical records by the staff to ensure that the complete medical history of each patient is maintained and is updated at each visit. These basic steps ensure that false claims and possible audits are avoided and revenue maximized.
  • Coding And Billing Properly – Medical billing services basically deals with the diagnosis of aliments with CPT codes. The most crucial aspect of medical billing lies in accurate diagnosis and allotting the correct codes for the specific medical problems. The advancement in the medical practices leads to a greater number of specialized codes being utilized for specific disorders and procedure and the chances of error is manifold due to the number of codes and categories. The updating of your EMR database repeatedly is the only surefire way of avoiding these falsified billing charges, mismanagement of claims and improving revenue.
  • Updating and recording medical data electronically - The recording of the patient information and all data pertaining to the medical condition of the patient in accordance to the HIPAA approved format is crucial to avoid the malpractice and fraudulent claims against your practice. Various Medical practices are coding using ICD-9 Codes whereas the healthcare industry has moved to the ICD-10 coding. The coding changes in the medical billing are frequent due to its specialized nature of its services and more difficult to follow and adopt in time. The importance of regular analysis and inspection of the medical data is paramount to retain accurate patient information and records.
  • Filing Reimbursement Claims after Scrutiny – The importance of a detailed analysis and checking of billing and coding details cannot be emphasized enough. A large number of malpractice suits, audits and financial claims arise by the inaccurate filing of reimbursement claims. The detailed checking of all claims will go a long way to increase the revenue of your medical practice.
  • Conducting Monthly Audit Reviews - The practice of including weekly and monthly audits reviews is a perfect way not only check for repeat mistakes and improve the billing proficiency but also increase the productivity and profit of the medical billing cycle.
  • Tracking patient satisfaction – Medical practices are basically dependent on the skill and the medical equipments used by the Medical Practices. The satisfaction of the patients is dependent on the services rendered, awareness of patient requirements and accuracy of diagnosis offered to them. The difference in the expectations and frustration leads to disappointment and discontent mainly due to untrained medical staff or inaccurate billing procedures leading to the unprofessional conduct and claims subsequently. The perfect solution for providing the finest care to patients is that your practice must base Medical billing on a fee-for-value or a pay-for-performance model.

Medicalbillersandcoders.com is a medical billing expert that aids your Medical practice in using medical billing procedures that are compliant to the latest medical reforms. Not only do you safe guard your medical practice from malpractice and negligence claims but Medicalbillerandcoders.com ensures a substantial increase in your revenues.

 

Category : Revenue Cycle Management