How can my practice thrive in such an unstable healthcare environment? This is the most common question asked by many physicians as the revenue is declining and physicians are working more for less revenue. Especially small and medium practices are bearing the brunt of healthcare reforms that have put tremendous pressure on the providers. Unless they have a streamlined business procedure in place, they will continue to be at risk of reduced revenue.
It has been observed that between 5-25% of payment for physicians is either denied or delayed due to coding errors
According to a survey, lack of patient eligibility is the reason behind approximately 75% of denied claims
4 Problem Areas that need your Attention
In this article, we will be discussing four major problems areas that can be improved to enhance practice earnings.
Lack of AR follow-ups
The first and most dangerous setback that affects practice revenue is the lack of AR follow-ups. Usually, clean-up of old AR accounts is not given priority because in-house billers are already busy submitting claims and following-up with insurance companies for payment. Accumulation of accounts receivable can damage the financial health of small as well as large medical practices. It is necessary to have a team of dedicated AR callers who know their job and work 24/7 to procure payment, turning old AR into real money.
Second major setback that affects the bottom line of medical practice is coding inaccuracy. Coding errors can be costly if they go undetected. Practices need a team of expert coders who are skilled in error-free coding. With ICD-10 approaching, physicians will need a strong team of coders who are skilled as well as certified to handle the complexities of the new code set.
Lack of Eligibility Verification
Insurance eligibility verification is the first and most important step in medical billing. If the correct coverage information is not provided by the patients or if the staff forgets to update the latest information, it will directly impact the chances of getting paid on time.
Mistakes in documentation are the fourth major setback that eats up much-deserved revenue for physician practices. If documentation doesn’t contain accurate information, coders won’t be able to assign the right codes. Getting the documentation right is extremely important if physicians want to get maximum reimbursement.
A growing number of medical practices are outsourcing their billing and coding needs to a third parties. This is not only giving them sufficient time to focus on quality care but also to eliminate their worries of hiring, training coders and billers and making necessary system changes.
Procuring Maximum Payment with MBC
By choosing to outsource with MBC, physicians have realized the importance of streamlined billing procedure. They are relying on MBC’s team of expert coders and billers who are well-versed with billing requirements for 42 different specialties. This gives them ample time to focus on patient care and perfect their documentation skills, without worrying about payments.
Published By - Medical Billers and Coders
Published Date - May-19-2015