Few would argue that an efficiently run revenue cycle is crucial to the health of a medical practice. In the healthcare industry we have to deal with the added challenge of, more often than not, being paid by a third party long after the patient has been treated. Furthermore, if a claim is denied by the patient’s insurance company, it will be costly and time consuming to secure that payment. At ProMD Practice Management we have been providing billing services to healthcare professionals for many years. We have put together a list of the most important steps you can take to make your revenue cycle run as smoothly as possible and keep the income flowing in.
A simple outline, preferably in writing, is all that is needed for the billing staff to compare their work to. It should include all of the important steps that need to be taken to properly complete a claim form, from verifying coverage to sealing the envelope and putting a stamp on it. Post the outline where the billing staff works so that they could refer to it each and every time they prepare a claim. This simple step can significantly cut down on errors.
We are not going to say that insurance companies are looking for a reason to deny your claim, but there are a number reasons why they might. Insure that your billing staff is submitting clean claims. That means that all of the information on it is correct and that the bill is filed in a timely manner. Common mistakes occur when filling out diagnostic and treatment codes as well as patient demographics. Some medical practices employ a “scrubber” whose primary responsibility is to give claims one final review before they go out the door.
Many of the medical practices we have worked with schedule a single day of the week to get all of the claims out. Consider submitting claims every single day. The last thing you want is for a deadline to pass while you wait for the billing day to come back around next week. Daily billing also keeps the claims from piling up and becoming overwhelming for the billing staff. Also, make sure that denials and other issues are worked on every day.
This goes back to our earlier point. Insurance companies are not trying to rip you off, but don’t expect them to bend over backwards to pay you either. Make sure that you and your billing staff is familiar with the contracts you have with each payer and hold those companies to them. Fight denials if you think your practice is in the right, and have your staff go up the chain of command if necessary to get results.
Sometimes the insurance customer can get the job done. Don’t be afraid to make your patient aware of a denial that you think is unjust and ask them to advocate for you with the insurance company. We have found three way calls with the patient on the line to be very effective in getting the insurance companies attention. Just make sure you have done everything you can on your end before attempting this tactic.
A good billing company can take all of stress of dealing with insurance companies off the table for you. They make it their job to stay abreast of changes in billing regulations and payer rules and will get your claims out clean and on time. The best way to find a good one is to ask your colleagues who they use and how satisfied they are with the service. With the higher collection rates and the reduction in staff, you may even find yourself saving money. One of our specialties at ProMD Practice Management is billing services. You can choose from a-la-carte services or allow us to take over your entire billing operation. Our billing customers enjoy claim rates as high as 98%. Call ProMD today to learn how we can improve your revenue cycle.
ProMD Practice Management is happy to help with your billing assessment needs so you can maximize profits and increase patient satisfaction. To learn more about how ProMD can make your practice run like a well-oiled machine, call 888-622-7498 or fill out our online form to request a billing assessment.
ProMD Practice Management was founded in 2004 by a team of physicians and health services administration professionals who had directed the expansion of South Florida Perinatal Medicine into one of the foremost maternal fetal medical practices in the state.
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