As per the Medical Group Management Association (MGMA) increasing the revenue of the practice rely largely upon filing correct claims which satisfy all reporting guidelines, filing appeals, and tracking denials within the timeline. Apart from this, keeping your business financially healthy is not a simple practice as practices changing from the free for service model to value-based care.
There are several procedures that can affect the bottom line of a practice. Many physicians depend on medical billing services in order to tackle associated challenges. Moreover, physicians require to work closely with medical billing and coding organizations to find out similar areas, which can have a powerful impact and assure improved bottom line.
Some issues with reimbursement can be tracked easily to the requirement for proper management and allocation of work in the back office, on the other hand, other problems relating to insurance coverage should be managed by your front desk staff.
Here are seven ways coding and billing strategies can improve your revenue:
1. Know how to implement procedure and diagnosis codes that are common in your practice
Proper ICD-10, as well as CPT codes, are needed for gaining better reimbursement for office visits and evaluation/management (E/M). Coding thoroughly and properly is critical for reimbursement as well as maintaining quality parts. Some of the common errors of coding are cheat sheets, partial and wrong description of code on encounter forms, and electronic charge system. Keep in mind to connect diagnosis codes to appropriate CPT codes.
2. Keep an eye on updated coding regulations and resources
Every year the American Medical Association (AMA) modifies its CPT books for adding and eliminating codes and changed guidelines that are in line with the CMS requirements to be followed by applying new ICD-10 codes. Your practice should use the best resources to make sure that reporting is compliant and correct.
3. Utilize modifiers properly
Modifiers can be utilized with HCPCS as well as CPT to notify the payer of certain circumstances. Using incorrect modifiers or not using it can result in not only billing mistakes but also in claim denials. Medical coding service providers make sure that coders are educated to exclude these errors and utilize the correct modifiers.
4. Allocate a dedicated person for the claims supervision internally
If you can allocate a special person who can identify and flag claims which are about to reach their deadlines for the appeal of declined claims or resubmission. Moreover, that person can find out requirements for extra documents, follow-ups, tracing resubmitted claims, and to make sure the payer should receive any kinds of resubmission within the timeline.
5. Read provider notes thoroughly before coding
Coders require to read the notes of the providers completely without a hurry and cross-check that important information. For instance, reading only key points instead of reading complete information.
6. Keep an eye on important measures
Though medical billing organizations offer time to time financial reports, physicians require to have knowledge about information in order to make informed business decisions. Some of the key metrics as per the physicians that can impact the revenue cycle are net collection, charge lag time, average collection per visit, and days in AR.
7. Avoid CCM denials
Reasons for Chronic Care Management (CCM) denials are insufficient documentation, billing of CCM more than one time in 30 days by physicians, and billing of CCM for the same patient within given 30 days by numerous providers. In order to resolve mentioned concerns practices require to talk with specialists for who is the concerned party to bill for CCM and make sure CCM is billed on time.