Medical billing is a tremendously complex and evolving part of the health care industry. Revenue Cycle Management is the process through which medical billing services and insurance carriers are linked together to process medical bills. The medical billing structure has to be backed up by solid and infallible calculations. But in most manual billing practices, the chances of miscoding or overcharging increase significantly. It is thus necessary to have a steady and efficient way to breakdown the several steps that lead to successful medical billing practices. It includes patient appointment registration, double-checking correct coding practices, accurate claims filing, keeping an eye on adjudication issues, following up with the insurance carrier and lastly collection of payments.
Medical billing services in the US must abide by the current changes in health care laws and regulations. Medical billing mistakes can take a hefty toll on the doctors providing quality care to patients. As more than 80% of medical bills submitted have errors. A single slipup can drastically change the final medical bill. This has led to the growing need for outsourcing medical billing services. This article aims to highlight the key factors that affect physician reimbursements for the services rendered.
Avoiding Medical Billing Mistakes
Doctors in the US lose billions of dollars due to medical billing pricing inaccuracies each year. From the initial appointment with a health care provider to the final payments, several ambiguities affect medical billing. Delayed payments are one of the primary concerns of most healthcare providers. Catching small errors related to medical billing and coding services can help reduce denied bills. Preparing and reviewing bills for completeness and following up on unpaid claims is extremely crucial to ensure steady workflow and revenue. The incorrect use of coding, along with patient eligibility verification and a lack of knowledge about medical jargon are the most frequent causes of medical billing mistakes today.
Usage of the Right Information and Communications Technology
Medical coding is a crucial step required to submit medical claims. This includes accurate information regarding diagnosis, procedures, medications, and equipment. Medical coding allows for the efficient transfer of huge amounts of information with precision. Medical coding can measure and relay personal health information to help control costs and raise patient satisfaction.
Being Up-to-Date with Explanation of Benefits (EOB) or Denied Claims
Explanation of Benefits or most commonly referred to by medical billers EOBs are how commercial healthcare insurers and government healthcare programs notify their beneficiaries, and how an individual healthcare claim was processed for payment. Filling clean claims is the safest way to ensure accurate payments, as it reduces the need for claim resubmission and claim denials. An EOB outlines very important information to track all health expenditures of each patient. This includes dates of service, claim numbers, provider information and types of services rendered. Thorough knowledge of claim denials and when to appeal them is indispensable for a dependable medical billing practice today.
Investing in Staff Training
It is crucial to stay abreast of the latest changes in health care regulations. This is especially important for medical billing staff to produce timely submissions of medical billing claims. Thus a streamlined process in which the staff is trained in the dynamics of insurance companies to sustain the longevity of any reliable medical billing practice is essential. Deciphering medical reports, being adept in medical coding, understanding claim denials and to accurately provide viable solutions are some of the core competencies for a quality medical billing and coding company. To help maintain the quality of a medical billing practice the staff must be well versed in all medical coding, health records management and medical terminologies for various treatments.
Doctors face an influx of patients with major health care challenges that need individual research and attention to detail. This includes providing life-saving health emergency treatments. As for doctors, it is a rather strenuous task to constantly seek a way to attain their payments on time. Thus the significance magnitude and importance of a Medical billing and coding practice cannot be denied.