Billing is a crucial aspect of the success of any medical practice. Billing procedures that are streamlined, accurate, and efficient have a tangible positive effect on the growth and consistency of a practice’s cash flow. While factors like size and specialization change the specifics of billing procedures from one practice to another, the ability to provide quality patient care depends on the properly organized and timely billing of encounters in many ways. Considering proper billing is linked to a practice’s financial viability, there is always room for improvement.
Why is Efficient Billing Important?
Any improvement or streamlining that can be applied to your billing process can yield lucrative results, helping a practice invest more time and money on the quality of patient care that keeps people coming back. Inefficient or inaccurate billing can mean coding errors, uncollected revenue and patient dissatisfaction with the process, three things any practice should work hard to avoid.
Eight Strategies to Improve the Medical Billing Process:
Even the smallest adjustment to a practice’s billing procedures in the right areas could save both time and money, but where do you start, and what can be changed? Here are eight strategies that any practice can use to improve its billing procedures and maximize its revenue stream’s potential.
1. Automate Simple Aspects of the Process
Nine times out of ten, billing errors are a result of human error. This is understandable and a fact of life in any occupation where people are involved, so while the risk of human error can’t be eliminated entirely, the likelihood of mistakes can be diminished.
One simple way to accomplish this is by automating extremely simple aspects of the billing process, like data transfer. When it comes to transferring patient or service data, all it takes is one typo to incur a claim denial.
Most medical practice billing software includes options to automate aspects of the process. Applying those features in areas commonly considered too simple to mess up lessens the likelihood of unintended mistakes while streamlining the process overall.
2. Improve Follow-Up by Keeping Track of Claims Denials
For a variety of reasons, from late filing, bad demographic data and faulty payer edits to reduce justifiable reimbursement, insurers will inevitably deny a growing percentage of claims. It’s then up to billing staff to refile or appeal the claim to correct the respective issues.
Neglecting to do this could lead to late filings and reduced or no payment. Keeping a close eye on denials and ensuring they’re all properly addressed in a timely manner will minimize this issue.
Practice management billing software often includes tools to track claims denials, but without a dedicated effort being made to follow up on claims responsibly, mistakes can be made and denied claims can still be filed late resulting in no compensation!
3. Ensure Patient Records and Other Important Info is Accurate
Proper billing of services can be nearly impossible to perform if the information about a patient is inaccurate or out-of-date. Inaccuracies in patient info don’t just mean a heightened potential for inaccurate or ineffective treatment for the patient; it also can lead to improper billing of those services.
Considering improper billing often slows down the billing process and can easily result in a claim denial, ensuring the information that your practice has on file for its patients remains accurate and up to date is extremely important.
If your practice is looking to avoid patient information that is out of date or altogether inaccurate, incorporate patient information updates into the typical office visit workflow. This way, patient info will always reflect what was established in their last visit, resulting in accurate billing for the current day’s encounter.
4. Upgrade Your Billing Management Software
In some ways, choosing the right billing software can be integral to ensuring a practice’s billing staff are able to perform their tasks in the most efficient and organized way possible. Sometimes inefficiencies or inaccuracies in the billing process can be eliminated merely by choosing a newer or more intuitively-designed software.
Some medical practice billing software can be outdated, overly complicated, or simply cumbersome to use, making organization and performing the most basic duties of a billing staff more difficult than they need to be. Investing in newer billing software can also introduce new avenues for streamlining the process with automation and other quality-of-life features specific to certain software.
Just because the software your practice currently uses is the one it has always used, doesn’t necessarily mean it’s the best fit; sometimes, updating that software or replacing it with a newer system can dramatically streamline the billing process and help billing staff attain better results.
5. Regularly Re-Train Practitioners and Billing Staff in Coding and Billing Procedure
Sometimes, human error can set in when employees aren’t provided opportunities to refresh their knowledge of their responsibilities; this is applicable to almost any work field, and medical practices are no different. In order to keep their skills sharp and to curtail any negligence that may develop, regular training is important, and something any employee can benefit from.
In the case of medical billing, retraining and staying up to date of changes is just as important for medical practitioners as it is for billing staff. When medical practitioners receive opportunities to refresh their coding knowledge, they are able to code their encounters more accurately. Accurate billing can’t happen without accurate coding.
For billing staff, re-training can be equally beneficial when it comes to refreshing their knowledge of the billing and follow-up process, ensuring information is processed correctly and handled in an organized manner. Re-training can help billing staff feel better equipped to perform their jobs while also further reducing the likelihood of billing errors.
6. Regularly Follow-Up on Unpaid Claims of 60 Days and Over
Ideally, your practice should aim to receive reimbursement within 20 – 50 days or fewer, depending on the complexity of the case (some specialists) and the type of carrier. Considering it’s not unheard of for services rendered to not be properly reimbursed within 60, 90, or even 120 days after a patient’s initial visit, regular follow-up is necessary to ensure the services your practice provides are being accurately paid for.
In order to avoid these outstanding unpaid services, it’s important for your billing staff to regularly conduct follow-up, contacting those who still need to pay in hopes of receiving the money your practice is owed. A/R of over 60 days is usually when more deliberate and intense follow-up efforts should be prioritized.
If your practice is experiencing patterns in the types of payments being delayed, regular follow-up can also help detect solutions that could improve your billing processes, ensuring patients are less likely to delay their payments.
7. Minimize the Likelihood of Coding Errors
A great way to minimize the possibility of billing errors is to understand that correct billing starts with accurate coding. Sometimes, medical practitioners will code an encounter in a vague or inaccurate fashion, such as not including the proper modifiers and diagnosis codes that differentiate one type of encounter from another.
If coding or documentation of the visit for an encounter is inaccurate, or simply not precise enough, these wrong codes could be billed to the insurance carrier. Under these circumstances, billing could potentially be accurate by the standards of the coding provided but not necessarily accurate as to what actually took place during the encounter, resulting in lost or incorrect reimbursement being sought.
To avoid this, it’s always useful to double-check coding to ensure accuracy and to make sure medical practitioners are staying up to date with relevant changes in coding guidelines. To better ensure codes are specific and precise, care providers should take notes, thoroughly detailing the service provided and the patient’s condition and presenting problem(s).
8. Establish a Clear & Transparent Financial Policy with Patients
The best way to reduce the amount of follow-up and delayed reimbursement for services rendered is by merely ensuring patients are as informed as possible about their financial obligations.
When a patient better understands the financial responsibility they’re incurring by using the services of your practice, they are ideally more likely to pay the full amount for them, considering they know what to expect up-front.
Be sure to provide numerous options for payment while also making sure to collect as much of the patient responsibility upfront as practical. In the age of high deductibles, more of the service on average is due from the patient rather than the typical copayment as listed on the patient insurance card.
It’s also good practice to hire front office staff that are able to speak calmly and respectfully to patients when discussing the cost of services rendered. The right tone of voice and attitude towards them can do a lot to determine their outlook over the price of their services. Offering flexible payment options, and ensuring you’re as transparent about their payment options as possible will ensure patients understand how to pay, and feel more comfortable doing so in a timely manner.
Looking to Streamline the Billing Process? Consider Outsourcing
When looking for ways to improve the accuracy and efficiency of your billing process, making the switch to outsourced billing is a regular topic of discussion and a formidable option to consider.
While this blog outlines ways practices can improve their in-house billing, outsourcing can significantly improve billing without the potential for long delays caused by claims denials, or other factors that can arbitrarily extend the process. Additionally, outsourcing eliminates the costs and resources needed to hire, train, and facilitate a full-time billing staff.
Outsourcing is typically seen as a lucrative way for practices to save time and money on the billing process, freeing them up to allocate those resources to other areas that can maximize revenue. If you’d like to learn more about outsourcing vs in-house billing, refer to our blog post on the topic here.
Conclusion
Billing services aren’t just important because they ensure a practice has the revenue it needs to run effectively, that revenue also ensures patients are provided effective care with quality equipment, adequate numbers of professional staff, and access to a wide variety of resources. Organized, timely reimbursement is the only way medical practices are able to provide their services effectively and accurately.
From decreasing the likelihood of error, to ensuring patients are expected to pay for services rendered, any improvement that can be made to a practice’s billing procedure and financial policies can be useful in maximizing the revenue it needs to run effectively.
The billing process is a complex, multi-faceted process, rife with avenues for improvement where even the best-refined systems can still include plenty of opportunities for improvement. If your practice is looking to refine its billing procedures, and further increase its potential revenue, there is no shortage of improvements to be made with the potential to yield long-term benefits.
