September 29, 2014
The hard truth that every medical practitioner, be it a biller or coder, is that the reimbursements are a pain. The insurance companies and other payers have a set of rules and regulations that every biller needs to follow. Non-compliance of it leads to claims denials and underpayments too. Statistics say that only 70% of claims are paid after they are correctly submitted at the first attempt. After that, around 60% claims get lost, or are either denied or ignored. It is also estimated that payers underpay practices by an average of 7-11%. A total of $125 billion is left on the table each year by practitioners. It is believed that if the medical practice doesn’t identify claims automatically, they’ll be denied.
There are many ways by which revenues can be increased and they are listed as follows:
Mention physician hours:
Doctors should make it a point to add office hours, end hours, evening and weekend hours. Also, they should make it a point to decrease the number of holidays they take and should rather take half days. Listing them will make a clear list of the claims that are to be provided and then they’ll be hard to ignore.
This should be added to recoup and streamline prescribing. They are used to reduce the complexity of the systems. PQRI measures should then be reported to recoup the additional revenue.
Grants Depending on Area of Practice:
If you are located in a rural area then check on the sources of grants or funds in the local area or of that state that can be helpful to your practice.
List Fees for Exams and Collect on Time:
If you conduct medical exams then a list of the fee for such services should be scheduled and they should be duly collected by your backend billing team.
Suitable Arrangements for Payments:
Make convenient and prompt payment arrangements in the office for maintaining monetary balance even after the insurance has been paid.
Co-Payment Collection at the Time of Appointment:
The portion of payment that has to be given by the patient should be collected at the time of service.
Know the Patients’ Insurance Status Beforehand:
Make sure to segregate the patients with insurance to the ones without it as it becomes easier to make to manage your revenue cycle and also saves time.
Maintain Cordial Relations with Payers:
Plan meeting with the representatives of the insurance company that pays the monthly claims in order to maintain a healthy relation as well as bring the problem areas that need immediate attention to their notice in a subtle manner.
Streamline Accounting Process:
The billing and accounting cycle should be given due attention and improve in order to produce accurate invoices and statements are matched up with the suitable packing slips and price tags.
An Educative IVR on Answering Machine:
The answering machine should be replaced with an informative Interactive Voice Response (IVR) that educates patients on the go when they call during the after-hours and it should also have an emergency number of doctors to contact at odd hours.
These small yet important steps from the administrative end go a long way to ensure the revenue cycle is supported duly. To focus more on your practice and lesser on the collection of bills and claims, it is essential that the doctors and hospitals hire medical billing and coding agencies to take care of this financial aspect. Companies like MedicalBillersandCoders.com could be helpful in providing you efficient services encompassing all your backend billing and coding needs. They are a consortium of trained professionals who offer highly customized services to over 42 specialties.