Getting paid quickly is a priority for every profession, especially if you’re in the medical industry. Unfortunately, the time between when services are rendered and when payment is made can often span months. Here are some medical billing tips that can expedite the process and improve your cash flow.
When you’re filing medical claims, knowing your patients’ basic information is as important as recording how you cared for them. Incorrectly completing the basic information sections on the HCFA and UB-04 forms is as likely a source of claim rejection as inaccurate CDT-10 codes. Take these steps to ensure accurate, clean patient information on all your claims:
It’s not just asking for patients’ information that matters; how you ask matters too.
Let’s say you’ve taken the first step and know your patient’s insurance will cover your services with an $80 copay. You’ll want that $80 from the patient sooner rather than later. Take these steps to make that happen:
Editor’s note: Looking for the right medical billing service for your business? Fill out the below questionnaire to have our vendor partners contact you about your needs.
If you handle your medical billing in-house, rejected claims could take you several weeks to resubmit. All that lost time means your cash flow won’t be quite what you need it to be. The thing is, many claim rejections result from simple errors you could easily catch at the outset of the medical billing process. Before you file your claims, check that the patient’s demographics and insurance information are accurate. Make sure the correct provider is indicated. This way, you won’t wind up with a rejection due to simple errors.
Another major source of claim rejections is incorrect medical coding. Since there are staggering numbers of five- or six-digit codes for medical services, it’s easy to code a claim incorrectly.
Where humans can’t check for errors, that’s where claim scrubbers come in. These automated programs, which often come with third-party medical billing services and clearinghouses, match all codes on your claims with the actual services for which you’re billing. The program will flag any mismatches as errors and tell you how to correct them.
Of course, like all software programs, claim scrubbers aren’t perfect, so you’ll want an expert medical coder to look at the findings before making the changes. The combination of machine efficiency and coding expertise vastly improves medical billing and coding outcomes.
No matter how much work you put into rigorously checking your claims before filing, rejections and denials are inevitable. What happens next is up to you and can have a noticeable impact on your cash flow and billing costs.
The good news is that handling rejected claims is usually simple. Look at the errors the payer has indicated, then correct them and resubmit the claim. This process is typically quick and pain-free, even if the time between resubmission and payer reimbursement is long.
Rejected claims, though initially stressful, are often quick and easy to address.
Denied claims is another matter entirely. When claims are denied, payers are supposed to provide you and the patient with EOBs to explain the issue. However, payers may forget to include EOBs with their denials, leaving you in the dark. Even if they do provide EOBs, you have a question to answer: Is filing an appeal worth the time and money?
While you might be able to offload the burden of appealing a denial to the patient, it’s not uncommon for practices to do so on the patient’s behalf. In fact, third-party medical billing companies often include denial management with their services. In many cases, outsourcing your medical billing to these companies can prove well worth the price tag.
With the best medical software platform, you can streamline your front-office staff’s billing tasks. The practice management software (PMS) side of medical platforms, for example, can significantly expedite the intake and patient payment tips detailed earlier in this list. Most medical software platforms pair PMS with integrated electronic medical records (EMRs), which can auto-populate your claims with service details that improve your coding.
When you outsource your medical billing, you entrust your entire cycle to an external full-time staff of medical billers and coders instead of your own front-office staff. In doing so, you free your front-office staff’s time for patient-facing matters and hand over your revenue cycle to highly qualified experts. These experts often have access to powerful, exclusive claim scrubbing and denial and rejection management tools.
The combination of medical software and outsourced medical billing can result in a practice with less cash held up in accounts receivable and more money immediately available on hand.
No matter what experts and software you have in your backyard, stay tuned to shifts in your specialty and the general medical world. That might include changes to state medical laws and updates to CPT-10 and ICD codes. Such alterations can lead to changes in your medical billing and coding process big enough to result in rejected or denied claims. To avoid that fate, keep an ear to the ground. The result will be an easier medical billing process for your team and more revenue for your practice.
Streamline your operations with some of the best medical billing services available, including:
Danielle Fallon-O’Leary contributed to this article.