News

Medical Billing and Revenue Leakage: The Right Strategies to Improve Your Reimbursements

In the healthcare industry, medical billing and revenue leakages can result in significant loss because of long payment cycles. These include the billing process, right coding insertion, and raising claims for insurance companies to receive quick money reimbursement.

There are notable loopholes that should be monitored to ensure a steady cash flow, which will provide stability to your healthcare facility.

In this article, we'll outline the major issues and outline our solutions to them in order to improve your reimbursements.

Rejection of Claims or Denials

This constitutes the most common issue in medical billing and is detrimental to your cash flow since rejections or denials come directly from the payers like insurance companies or co-payers.

This situation arises mostly because of errors, wrong data, wrong coding, or claiming your money under an insurance policy that has expired.

Our Solution Strategies

• Conduct learning sessions for your staff and educate them about the latest changes in coding. 
• Place a sequential coding system that must not generate the same number.

All these steps will surely increase billing accuracy, minimizing their rejection or denials.

Incomplete Documents or Coding Errors

You should make documentation a priority, beginning with the moment a patient approaches your front desk or calls your center to make an appointment. Such initial care can prevent billing errors and delays in processing claims.

In addition, accurate coding is another step to avoid or optimize steady revenues. Correct coding deals with two aspects. First, it will help improve your compliance, and second, it will reduce the odds of a bill being rejected or denied.

Our Solution Strategies

• Ensure proper collection of patient data, information, health insurance policy reference, and the correct code for the service.
• Make note any patient referrals on their respective files.

Payer Contract Enforcement and Compliance

This is another aspect in which the payer or co-pay will underpay you. Tracing an underpayment is difficult, and complications will arise if the payer utilizes different payment methods to cover the same service. As a result, it is necessary to implement a seamless bill process method and proper follow-up. And in these situations, a professional and well-trained staff are necessary.

Our Solution Strategies

• Make use of the latest software and other relevant technology to upload all your contracts and fee schedules.
• Define a policy that outlines extreme situations for underpayments or overpayments.

Monitoring Collections

Most healthcare centers or medical practices are forced to pursue payers or insurance companies for account receivables with limited or no success at all.

You should always be prepared to deal with the claim successfully by working on follow-up promises. Make it simple and clear, and refer to overdue payments only.

Our Solution Strategies

• Create a list of codes and train your collector on the extensive usage of the appropriate codes.
• Advise your debt collector to start with a flexible approach with the option to postpone, but not exceeding a week’s time.

Conclusion

A steady cash flow is a lifeline for all businesses. The guidelines we outlined in this article will help optimize your billing collections.

Let us work with you to implement the right strategies to prevent medical billing and revenue leakages in the first place. Our expert consultants will review your reports, trends, industry changes, and policy updates to provide your business with the right feedback and solutions to improve your entire billing process. To learn more about our commitment to excellence and performance for medical practices and healthcare providers or for questions regarding our tailored revenue cycle management solutions or other medical billing services, connect with us today.

References

https://bit.ly/39wwr48

https://bit.ly/3oz1ZL5

https://bit.ly/3cpSEmo

Questions?