Medical billing and coding are a vital aspect of your practice operations, but for small and medium-size independent practices, it’s often one of the most overlooked aspects. There can be a situation that you might be seeing the payment denials with the same or more patients, or you are unable to reimburse on a significant portion of your billed charges, here you go it’s the first step to evaluate your medical billing workflows.
Here are important things your in-house staff or outsourced medical billing company can do before the claim goes out to ensure you are able to reimburse as much of your billed charges as possible.
1. Verify Insurance Multiple times
Insurance coverage or information is the common reason behind almost many rejected or denied claims. That could be incorrect patient demographic information (e.g. spelling mistake in name, wrong date of birth), or changes in insurance coverage.
In a few cases, it is very simple as correcting a negligible error, e.g. a misplaced text or number in the patient’s insurance ID. In other cases, it can be complicated; e.g. a patient that had insurance but it is not covering treatment. That is especially significant to check right now as many patients are experiencing job loss as a result of the COVID-19 pandemic.
Even when there is a simple mistake, it takes time for your medical biller to find out what went wrong, to correct it, and resubmit it. There are time limits that payers require to get these corrections. If your practice misses these timelines then you won’t get paid.
It is an easy and good solution to use your medical practice management software to cross-check the patient’s insurance coverage, once when the patient schedule an appointment. Your billing company should also check insurance coverage right before the appointment. This way if there is any error then it can be identified and corrected well in advance.
2. Use Technology to improve payment collection
Once your medical billing team submits the claim to the payer and there is still some outstanding balance. You can send an invoice to your patients by email. But it is actually more effective to send them an automatic notification about their invoices are due.
Follow-up text messages and an email reminder can save your practice to cost of mailed paper billing and more likely to produce an immediate response from a patient.
It is crucial to have a method for have an online invoice payment to patients so they can easily clear outstanding balances without the need to mail a check.
3. Use of Software
When your front desk enters patient information into the EHR, you need that information to transfer to the billing department fast and simply. If you are using two systems and those are not interconnected to transfer informationbetween them, that means someone has to manually enter information from EHR and input it into medical practice management software. This activity takes time and increases the chance of an error in data.
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