How to Arrest Revenue Leakage in Medical Billing?
The revenue cycle in medical billing is a complex network of interconnected processes that manage and collect payments for hospitals, doctors, and health care systems for the services provided to their people. These include patient insurance and benefits verification, insurance prior authorizations, patient registration, medical coding, charges, claims filing, payment posting, denials management, and generating reports. Inefficiency and carelessness can lead to revenue leakage in these stages, leading to thousands of dollars’ loss if undetected.
10 Things to Implement to Reduce Revenue Leakage in Your Practice
Right Medical Billing provides you with the things that would help you reduce revenue leakage while working hard, trying to keep the lights on. These guidelines can help you increase revenue and reduce costs.
1. Avoid Credentialing Related Denials
Practices should understand that ignoring a provider’s failure to participate in specific health plans can increase denials. A professional team should identify and re-credential the complexities of payer-specific credentials requirements and reduce denials. The outsourcing of your provider’s credentialing to the credentialing company can significantly reduce denials.
2. Un-Billed Procedures
Physicians should be aware of verifiable procedures to prevent unrecorded minor procedures. Knowledge of physicians to check methods reduces unchecked techniques and improves revenue. After a detailed conversation with the physician, a medical professional can usually detect revenue leakage due to unbilled procedures.
3. Un Billed Claims
Un-billed claims are the result of the loss of more revenue than any other cause. These claims can be recognized by linking reports of patient’s appointments, procedures performed & claims submitted.
4. Managing Patient Balances
Develop an efficient patient balance management process that will include timely patient recall/texts, electronic payment methods, and flexible payment plans, which will ensure a maximum refund.
5. Underpayments
One of the highest revenue sources is to know the exact cost of your services. Within different insurance companies, deductions can be avoided by planning and revising your fee schedule promptly. Ask expert support in setting up your timetables.
6. Fee schedule problems
Fee schedule problems can be addressed every month by updating your timetable. Your practice can identify those areas where you are paid less. For a process, fix your fee schedule 2 to 3 times the Medicare’s applicable charges.
7. Inefficient Claim Denial Management
Denial management is a critical step in the RCM direction and requires the highest levels of expertise. Hire a professional team that can submit negated claims again, understand why refusals occur and create an iterative procedure to avoid future denials because of the same problems.
8. Personnel Issues
The inefficiencies or unsuitable training of reception desks and billing departments are causing personnel problems. Train your front desk staff to collect data accurately while taking care of patient’s empathy. Trust qualified and certified individuals who can submit bills and follow up immediately with your billing process.
9. Unleash The Power of Analytics
Today, most software for the revenue cycle offers several reporting features. Use these features to produce prompt reports on your practice’s operational and financial performance. Take necessary decisions while taking the main lessons learned from root cause analysis data.
10. Patient Centricity
As a healthcare organization, patient care and satisfaction are your primary responsibility. Create clarity about patient responsibility, establish flexible payment procedures, and create a customer service team to keep consistent patient contact.
