How to create a better Medical Claims Billing Process?

The process of medical coding and billing is complex. Billing can take from a few days to several months if a patient has a complicated enough case or has an essential medical history. There are ways to ensure that the billing process is the best possible, increasing the acceptance and submission rate for first-pass medical claims. There are several ways to ensure that the billing process is the best possible, increasing the acceptance and submission rate for first-pass medical claims.

 

Maintain & Update Your Patients’ Files

Confirm that for each patient visit the demographics and insurance information is accurate. Insurance carriers and cover limits can be adjusted if the patient changes employment or reaches an era at which they can be included in the Medicare program. Effective processing of claims requires the confirmation of the coinsurance percentage and the policy number and the verification of the insurance company’s billing address and ensure the subscriber details. Policy number matches the third-party payer’s record.

 

Train for Success

Every insurance company has its laws. That is why training programs are required to ensure that every carrier has the all necessary information to expedite the processing of claims after the request, which provides that the payment departments have access to patient files and filing specifications efficiently.

 

 

Track denials

The monitoring of your denials should take the form of your medical claims billing process. You get ideas into what might be wrong with your approach with each rejected claim. If your denial rate seems to be abnormally high, it could lead to extra training for your employees. You also have the possibility that your scrubbing is not enough. You will be able to determine what steps your practice should follow if you track your denials.

General denial reasons include:

  • Doctors are not adequately certified.
  • You may not have enough supporting records.
  • Your team uses codes for services or software that is not protected by carriers.

You can see simple steps the practice can take to improve productivity in monitoring denial codes. For example, it can save considerable time and increase the accuracy of submitting chart notes to the billing department and billing codes daily. Similarly, if claims for services considered “non-covered” are repeatedly returned, this could mean it is time to check the verification process and the coding protocol.

 

Outsource Your Most Problematic Collections

You and your fellow stakeholders may refuse to consider outsourcing work as providing service in the community for several years now. But, mainly when the quality of your turnover is at stake, it is wise to keep an open mind. Working with a third-party revenue cycle management company liberates the workers while leaving experts with the most complicated collections. They are compassionate and sensitive to help the patients cope with their unpaid charges, such as creating a payment plan. Your staff can no longer suffer the heaviness of frustrated patients with difficulties paying their bills.

 

Enhance quality control

As many claim errors as possible must be eliminated. However, it does not mean your billing and collecting process is complete only because your claim is accepted. If you use generally agreed accounting standards to post and report the expenses, the medical provider can easily track cash flow.

You can ensure correct balance sheets to build a deposit log that you can transmit to your accounts department. Make sure this log has all the details you need to provide accurate posting and allow reviewers to check that the correct payment is made without hassle on any account.

 

 

Right medical billing is here to help.

It is vital for the organization’s health that your workers be qualified, and the necessary services are given to deal with accurate claim processing. Before you and the other staff can take advantage of modern billing technologies and services, there is much knowledge to learn on the subject. You can call us on (281) 864-0448 from Monday to Friday between 8.30 AM to 5.00 PM for any queries and let our team help you choose the right solution.

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