Running a successful and sustainable medical practice in today's time is so much more than just providing adequate healthcare and researching new diseases. Current financial scenarios in the economy, latest policy developments in the healthcare sector and the advent of new age medical management procedures require the medical professionals to take a new look at the whole process of medical billing and coding in fresh light.
Today, following a proficient mechanism that emphasizes on a remunerative Revenue Cycle Management (RCM) is an absolute necessity for all healthcare providers. The structure involves complex micro management of tasks which begin at the time any patient makes an appointment with a doctor. Insurance eligibility verification of the patient, coding, charge capture, claim submission, payment posting, statement processing and tracking of the claims are some of the micro tasks that need to be catered to for efficient revenue generation exercise at medical institutions.
In most cases, the sum charged doesn't tantamount to the sum earned due to grave discrepancies in the medical billing procedure. The shortcomings involve delay in payer reimbursements, outright denial of claims, inadequate payment and collections from patients or other lengthy hauls that make the whole procedure tedious for any medical-craft focused institute to adhere to.
For any medical practitioner the source of income can be segregated into two broad categories i.e. claim settlement by insurance companies according to the terms of insurance contract between patient and the company, and the amount that the patient pays directly out of his pocket. A well maintained medical billing apparatus ensures a healthy revenue cycle. Irrespective of the laborious procedure of medical billing claim settlement there are ways all you can swell your revenues sustainably and diminish your account receivables. Take a look at these factors that can help you shoot up your revenues substantially:
A prudent way to enhance the revenues generated from your medical practice would be to take a second look at the payments generated, collection procedure and the time involved in seeing it through. In the revenue cycle of any medical establishment a part of the total account receivables are due to be received from Insurance companies as agreed upon. However, another section of the payment needs to be collected from the patients at the point of service which often gets delayed or neglected in the process of bouncing hence and forth between the clinic, the insurance company and the patient. These receivables when failed to be cleared often end up being written off resulting in massive losses to the practitioners. To achieve a goal of healthier cash flow you as a medical practitioner should work to strengthen the revenue collection methodology you have been using.
Effective Claims Management
Effective Claim Management is imperative for positive growth of your business revenues. Sometimes, some services provided by you as practitioners can go unbilled due to inept billing processes and can adversely affect the revenues of your practice. Moreover, at times submission of claims to insurance companies runs futile as they get rejected on technical grounds. Re-filing claims also incurs cost. Rejection and re-filing can be lengthy procedures and can hamper even the most efficient billing cycles. Thus, Effective Claim Management can come to rescue to positively affect your revenues.
A significant portion of revenues comes from reimbursements made by patients after partially (or wholly) settling it with insurance companies. These payments include co-pays and deductibles. However, calculation of the exact amount receivable and determining the time it is to be charged can create confusion between patients and the staff. To enhance the revenues of the practice, the self-pays need to be managed efficiently with clarity of the time of payment, the amount to be billed at the time of treatment and the amount to be billed later.
Technology can aid a practitioner financially as well as it can scientifically. The whole procedure of medical billing that comprises of many varied tasks like verifying insurance documents, collecting co-pays, efficient documentation and the rest can be performed flawlessly with the help of suitable technology. Even the tracking of claims, their status becomes an easy exercise with the help of technology. Collecting the co-pays and deductibles through e-banking and credit cards reduce the risk of failure in self-pay scenarios. With aid of technology the revenue management can be managed relatively timely and more efficiently.
Trained manpower can be an indispensable resource for your medical practice. The whole Revenue Management procedure at a medical institution requires someone qualified enough to look over the process of medical billing and the many micro tasks it is made up of. In addition to working knowledge of medical billing the staff needs to have an insight into financial policies of government, the rules of insurance companies along with polished communication and negotiation skills. An expert billing team can handle appeals, pick out under paid claims and tackle them towards fulfillment, adjust fees besides billing efficiently.