Are there predictable and constant errorwith your medical practice accounts receivable administration services that are confining your facilities income? If yes, then there’s no need to feel left out, as more than 40% active practitioners and their facilities in United States are facing the same issues, which is directly plaguing their revenue collection.
There are a couple of constant but common medical billing and coding errors that healthcare units suffer through, let’s take a look at them, and the remedy to resolve those core problems.
Denied Claims
A standout amongst the most well-known AR issues tormenting healthcare units is denied insurance claims. You’ve likely heard the expression, “If you have to ask, you can’t bear the cost of it.”
That is the way the medicinal services community should deal with claim denial. Benchmarking the data for various sources we found out that average denial rate ranges from 10% to 25% of all claims submitted. However, according to the MGMA the best performing groups should have a denial rate of only 4%.
Despite, AR and denied claim being an industry-wide problem, less than two-fifths of practices actually appeal denied claims. This presents a significant lost opportunity for recovering the revenue owed to your practice, hospital, ASC and clinic, which can be resolved by making simple corrections. Keep in mind that your accounts receivable or medical billing staff should review all claims prior to submission to ensure they meet payer guidelines, and follow up on all denials.
Needless Write-Offs
If we talk about write-offs, one should understand that some are necessary, while many are not. These are regularly identified with the primary issue we already shared: denied claims. Rather than automatically writing-off denials, your billing team should set aside time to review each one. Even a single correction can lead to a profitable reimbursement that your facility needs.
Here are a few points to follow when managing write-offs with precision:
- Choosing which write-offs require managerial approval
- Observing or Monitoring each claim overtime
- Creating claim benchmarking and segregating them accordingly
How bad are the bad debts?
Patient duties now represents more than one fourth of the human services industry’s income, and rising bad debts is turning into an common or plaguing medical problem stagnating your AR.
It is no longer adequate to talk about patient responsibilities at the time of getting treatment. With a specific end goal to enhance patient collect, it is basic to start collecting it through the entire revenue cycle. Your in-house staff should be educated enough to start assembling all important billing and insurance data with a specific end goal to compute expected out-of-pocket costs and confirm the coverage, so that by the time of administrations the patient already understands and has agreed to their responsibility, and their insurance claim verifies what they already expect. Additionally, following up and staying up-to-date post treatment will heed to improve recovery and decrease bad debt.
Embrace a Culture of Collection
As a healthcare professional you enter the field with an end goal to serve the patients that come to you with certain physical disabilities or diagnostic problems. Therefore, it is normal for accounts receivables to be disregarded in favor of providing care or an exceptional patient experience. However, getting paid for services rendered is crucial for maintaining a successful and profitable practice and continuing to provide care.
In order to make AR a work priority, you as a physician need to embrace the culture of collection in your facility. Remember that aging and outstanding AR is the number one catalyst that eats up your profits. If the in-house charging department is falling short of completing the tasks, you always have the option of hiring a professional medical billing and coding organization that specialize in Accounts Receivable management services. With their expertise in appealing for denied claims and follow up practices your practice will surely benefit from their administrative services.
