In the healthcare industry, success is often equated with the quality of care and the practitioners' level of expertise. While this is true, on the operations end of every practice, the quality of the billing system in use is equally as crucial as the quality of professional service.
Billing and collections are the main determinants of revenue and profitability. They are the lifeline that keeps all entities in the healthcare industry operational.
As much as the focus should primarily be on the well-being and care of patients, billing and collections should always be noticed, or they can blindside your business. After all, medical practices - including those in the DME, Prosthetic and Orthotic enterprise, are first and foremost business entities. And as business entities, they can only thrive with the proper billing, collections, and accounts receivable management. Businesses could only be as good as their billing.
The current state of the US healthcare system does not paint a pretty picture for practitioners. The entire industry must catch up to an estimated $125 Billion in uncollected revenues yearly. More than frequent changes in billing rules and regulations are needed.
To make the scenario even more dire, patients' ability to settle their bills has been on a steep decline in the last ten years. Out-of-pocket healthcare costs are crippling the finances of many seeking medical care. For healthcare providers, there is a pressing need to take a more proactive approach to their billing methods.
What Are The Best Proactive Billing Tips To Practice In 2023?
1. Understand The Billing Process And Tracking Diligently
The billing starts with registering the patient, verifying insurance eligibility, and collecting the patient's portion at the time of service. Coded claims are eventually submitted to insurers, where the claim may be honored or rejected.
2. Prepare Your Staff By Investing In Their Training
Your billing process could only be as good as your staff. And your team could only be as good as their training. Note that the exercise is not only for new employees. As medical codes and regulations are regularly updated, so should your employee training program.
3. Take Full Advantage Of Technology
Automating as many steps as possible will save time and eliminate human error that could result in claims rejections and ineligibility.
4. Include The Patient In The Billing Process
Being upfront with patients creates an atmosphere of transparency and trust between the provider and patients, which can help prevent costly billing errors later.
5. Always Be On The Lookout For Billing Process Improvement
Healthcare providers should be highly adaptable to change and always integrate the new situation as part of the billing equation. It will be wise for health practitioners to track performance and keep up with healthcare regulations development. Reduce A/R Days with Outstanding Medical Billing
6. Institute A Comprehensive Collections System
There should be a collection system that is transparently related to all people involved, from the patients to the medical team to the billing and collections division.
Here is a list of suggested steps:
Establishing clear terms
Collecting patient information
Verifying addresses
Reminding patients about co-pays
Getting permission to leave messages
Collecting upfront
Establishing extensive payment options
Snail-mailing overdue bills
7. Avoid Medical Billing And Coding Errors
An estimated 80% of all medical bills contain billing or coding errors and would automatically be rejected. Due diligence could go a long way. Make a habit of double-checking before submitting claims. Hiring a medical billing expert, such as Proclaim Billing Services, saves you from payment delays and increases your clean claims rate.
Common Billing and Coding Errors Include:
Non-specific diagnosis code
Incorrect modifiers
Erroneous patient information
Wrong provider information
Incorrect insurance information
Duplicate billing
Insufficient documentation
8. Immediate And Proper Administration Of Denied Or Rejected Claims
A rejected claim has yet to be processed because it contains errors. On the other hand, a denied claim has been processed already and is regarded as unpayable due to violations.
In both scenarios, medical practitioners should handle them as soon as possible. Rejected claims should be corrected and resubmitted error-free, and denied claims should be appealed before re-submission.
9. Consider The Benefits Of Outsourcing To A Reliable Billing Company
There will be instances, however, when some healthcare providers could still be overwhelmed with billing and collections concerns even while using industry best practices.
Outsourcing medical billing and coding to third-party billing experts, such as Proclaim Billing Services, is ideal for smaller practices to ensure proper claims submission. This would free up time and resources so medical practitioners could focus on the heart of the matter – patient care, keeping up with current medical trends, and staff management.
Why Choose Proclaim Billing Services?
Suppose your practice is in the line of Durable Medical Equipment. Prosthetic and Orthotic, you need not look any further. Proclaim Billing Services is the industry leader in the expert management of billing, collections, accounts receivable, and claims processes. We have built our reputation by significantly reducing clients' billing errors, claim denials, and rejections, thereby improving their cash flow.
Let us take care of your billing and collections so your practice may focus on providing the highest quality service for your patients.