Medical Billing from a Business Perspective

Medical billing can be a very difficult task. It requires time, efficiency, and a proper knowledge of codes. Medical Practitioners might be proficient in their practice, however, many of them are not able to complete the precise documentation that is required for the medical billing procedure. It is often advised that one should always outsource or go for a software-based approach for their medical billing procedure. These are efficient and cost-friendly methods that have helped loads of healthcare organizations as well as individual practitioners to boost their revenue.  

The revenue cycle management of any organization is a very important aspect when we see it from a business perspective. Although the process of medical billing is not easy, it has the capacity to make or break the backbone of an organization. If claims get reimbursed properly, the revenue will increase but if the claims get denied, it will be a revenue loss for the organization. 

In this blog we will learn about some tips that will ensure your claims get reimbursed. If the reimbursement rates for any organization are high, the revenue chart will automatically show a growth. 

Tips to improve your medical billing procedure 

Let's take a look at some of the most important aspects while completing the medical billing process.  

Keep updated patient record 

It is very likely that the insurance coverage of any patient will be changed in between appointments. There are other changes too such as the address or any other information that may affect the billing and claims. Outdated information in the billing procedure might lead to a denial. These errors can be prevented by building patient information updates, in your office visit workflow. Organizations can use multiple tools that are available in the market where patients can update their information online.  

Build Coding and Documentation in your workflow 

To maintain a proper medical bill, one should always start with accurate coding and documentation. Your EHR system can prompt health providers to enter coding and documentation when the patient visits for an appointment. However, this is not a very efficient way because it will take time of the health provider. It will allow less time for other patients. When you build coding and documentation in your office visit workflows, it will save a lot of time for the provider. It will also help the provider to accurately code patient visits. This process eliminates the need for post-visit work.  

While developing the coding and documentation workflows, one should seek help from both providers and medical billing specialists. Providers can help you in developing a process that minimizes burden. Medical billing specialists can help you identify key areas, for strengthening documentation and coding accuracy.  

Integrate Practice Management Billing Software 

An EHR is not only a powerful tool, but it can improve your finances too. When it is combined with practice management billing software, your EHR can prove to be very useful with faster reimbursement and minimal errors. Integrated EHR along with a practice management system depletes the rate of data duplication, manual entry and associated errors.  

This software exports data about patient encounters from the EHR system and helps you in making the billing process more accurate. All the different processes are aligned in the same system. Using the integrated system, you can collect and update patient data, schedule appointments, bill the payers, and document the visits. It helps in providing a comfortable workflow and helps your practice earn more revenue.  

Automate Simple Billing Functions 

In the billing process, even the minutest mistake can lead to denial of your claim. It could be a human error, outdated information, typos, or transpositions. Even the slightest mistake will cause you trouble. This can be avoided if you automate any kind of data transfer where possible. It will make sure that only accurate information is being registered.  

If you integrate your EHR with practice management billing software, you can automatically access the coding and documentation from the patient’s office encounters to claims. Patient insurance information can also be linked with payer-specific coding. This will save the hassle of repetitive payer compliance tasks for your billing staff. You can also automate the process of checking a patient’s eligibility criteria so that you never have to face a denial. 

Targeted Training 

Practice management training and EHR training can help in reducing burnout and improve satisfaction within your system. Targeted provider training for coding and documentation can enhance the quality of data received by your billing department. 

The training should not be limited to the healthcare providers. Your medical Billing Specialists also need to be a part of this training. You need to keep the technical skills of your billing department up to date. It will reduce the Charge lag time, improve your accounts receivable, and decrease the claim denials. If you wish to get more out of your training plan you should target training sessions based on job role and comfort level with the EHR and EPM system. 

Implement a Quality Control Process 

A lot of medical bills contain errors that delay your reimbursement or result in a denied claim. Once you establish a quality control process, you will see the change for yourselves. You will notice reduced errors in your billing procedures. A strong quality control workflow can be built on your automated billing process which will ensure that the submitted claims are accurate and complete. There are many practice management systems that can be used to stop or fix errors in billing before submission automatically.  This will reduce the denials; however, these systems need to be configured and updated consistently before they can have an impact on your revenue cycle.  

Tracking Denials 

Most of the insurance providers deny up to 5 percent of claims. The most common reason for denial includes late filing, inaccurate insurance coverage information and data inconsistencies. Your billing specialist should actively refile the denied claims by fixing the errors. Keeping track of claims helps the billing specialists to spontaneously fix the errors without taking too much time. A practice management system is very efficient in tracking denials.  Tracking denials also help you to prevent future claim denials. By studying the reason for denials, you can find the common errors that are responsible for denial.  a revenue cycle dashboard allows you to track denials by payer and reason. This will help you to find problems and fix them.  

Manage your Delinquent Claims

Your organization should aim to receive the payment within 50 days of treatment. If your accounts receivable days are over 60, 90 or 120, your billing specialists should consistently do a follow up. These follow-ups take time, but they can really help in maintaining the revenue cycle or identifying the errors.  

If your practice has numerous patients with delinquent copayments. You can consider collecting the payments in the beginning rather than billing after the appointment. If you are struggling with timely payments from a payer, your staff can go and check if they need any adjustments in the billing process. 

These are some ways that can help you in improving your revenue cycle. A bill payment software is best suited for practitioners who want to manage their billing procedures on their own. It can help practitioners manage their medical claims efficiently.  

Now let's take a look at how Unify Medicraft can help you in improving your revenue cycle. 

How Unify Medicraft can help

Unify Medicraft  is claim billing software that is smart and reliable, which can make things easy for you. You will have all the time to focus on your business and practice. It is a cutting edge, unified cloud-based RCM software. We will ensure that you do not have to export or import EMR in the billing software. We will custom integrate them with your software for a smooth workflow. Unify Medicraft also guides you about how you can improve your coding to get maximized revenue and meet the value-based metrics.  

Unify Medicraft can make your medical claims billing process easier and streamlined. You can be sure about the billing if you are using the software.  

We believe that medical practitioners already have a huge responsibility on their shoulders. It will always be our honor if we can take some load off their shoulders.