Every Medical Practice visualizes itself to be successful. Apart from providing the utmost quality of care and having expertise in your practice you also must have a healthy revenue cycle management system to let your business sustain itself for years to come. Healthcare practices can direct their focus on growing their business and providing finer patient care. Incorporating Medical Billing software in your practice can be resourceful.
Understanding the billing process
The billing process may seem difficult at first, but it is necessary to understand the process even though someone else will oversee it on an everyday basis. With PrognoCIS Practice Management Software billing processes become effortless. It has a robust tasking system. Here is a simplified way to understand the process.
- The process begins with verifying and instantly identifying the patient’s insurance eligibility level and copayments.
- There are individual codes for every patient.
- These codes are entered into the Practice Management software which is then sent to various clearinghouses. For instance: In claim scrubbing, clearinghouses check for errors and verify if it is compatible with the payer software.
- The insurance claims are checked, and the insurers decide whether the claim should be approved or rejected.
- Accepted claims proceed towards payments.
- Patient payments in PrognoCIS are quick and easy. Copays and advances are collected securely via credit card payment that is securely lodged within the EHR (Electronic Health Record). Patients can pay through the comfort of their homes as data is entered directly into the practice management system. This also eradicates costly errors, time-consuming reconciliations.
Helping Your Practice Overcome the Hurdles of Medical Billing
Outsourcing Medical Billing services for your practice can help you simplify your business. Based on Healthcare Payments Insight’s survey data, higher levels of satisfaction were shown by customers who switched to emerging payment methods.
To mitigate issues concerning medical billing practices we need to have an active approach towards their billing procedures.
- Construct a Clear Collection Process: Patients need to be informed about their responsibilities regarding the payment process. Make sure to have the right address, phone number, email, photo ID, and other basic information during billing procedures, make sure to verify patients’ eligibility during all their visits.
- Oversee Claims: Medical bills are likely to contain errors. The most common causes of errors are incorrect patient information such as DOB, insurance IDs, incorrect provider details, errors in insurance information, duplicate bills, missing or unclear denial codes, and many more. It is necessary to double-check and go through all these details precisely to avoid errors.
- Lessen Coding Errors: In a claim, medical codes (ICDs, CPT, HCPC) describe procedures performed using standardized codes which make the claim process easier. Errors such as incorrect codes, mismatched and missing codes are noticed by clearinghouses before they become an issue. Make certain to double-check codes before submitting claims.
- Handle Denied or Rejected Claims: Within PrognoCIS PM systems, rejected claims that are not processed due to one or more errors and are put into a bucket to monitor daily for clarification. For denied claims, the denied claim area gives you the ability to sort and group denied claims.
- Know When to Outsource: Healthcare providers find themselves lagging due to the amount of time and labor involved in performing administrative tasks and billing procedures thus, they think of outsourcing their medical billing services to increase revenue and retain control.
Medical Billing Tips
Medical billing services are the process of submitting a claim and following up with the insurance company to receive payment for services rendered by healthcare professionals. This is sometimes outsourced, letting a dedicated third-party code and bill your procedures.
Here are some tips to manage medical billing in your practice:
- Utilize technology to its fullest.
- Take Advantage of your EHR.
- Lead, monitor and manage your Billing Staff.
- Review and document common reasons for claim denials.
- Discuss payment with patients.
- Make sure to run aging reports.
- Verify health insurance benefits.
Medical Billing Tips especially for Dealing with Underpayments
The healthcare provider’s underpayments represent the difference in a claim’s expected payor value and the payment they provide.
- Claims administrators should review payer contracts for mistakes and discrepancies on a regular basis.
- Medical billing is often a tedious task that can be improved with the use of software and guidelines and the process will be less time-consuming.
- It is pivotal to approach insurance companies, review contacts mindfully.
- Implement timely coding for E/M services.
Latest Trends in Medical Billing
The latest trends in medical billing are as follows:
- Blockchain: Industries all over have begun to implement blockchain into their work. Blockchain helps to simplify the payment process in medical coding and billing processes. It creates authentic data records showing all actions and transactions that take place with complete transparency.
- Automation: For revenue cycle processes such as medical claim submissions, insurance management, patient verification and eligibility, robotic process automation can be the best possible solution to gain efficiency and accuracy in the billing pattern.
- Virtual Care: Providing value-based care through digital technologies like telehealth has been on the rise since the pandemic. Patients can make payments through these platforms, further steam lining the revenue collection process.
Medical Billing is challenging and complex for healthcare professionals. Outsourcing billing services will reduce administrative burden, reduce errors, safeguard patient data leading to greater patient care, patient satisfaction, and enhanced revenue generation.