Healthcare reimbursement is a brutal business, and many practices find themselves losing out the battle on collections. While the use of charge capture services is a tremendous help, the entire billing team needs to be on the same page if the office is going to bring in the revenue needed. Statistically, medical claims are only paid at a rate of 70% on first-time submissions, and roughly 60% of any denied, ignored or lost claims aren’t resubmitted. There is a lot of money left on the table. Here are some tips for effective medical billing.
Catch Denials Before Submissions
Since so many denials don’t usually receive the follow-up needed to process the claim again, you can improve the efficiency of the process bybefore the denial happens. This means using software that established clear submission parameters and automatically flags potential denial claims. Artificial intelligence and machine learning are making processing software more reliable and are improving collection rates for users. The software also eases the burden on in-house staff and speeds up the collection process.
Many practices won’t receive full payment for the claims that are submitted, making payer underpayments a huge loss in revenue. The individual contracts between practice and physician establish different payable or collectible amounts, and it is natural for staff to get confused or be unaware of a payer underpaying. The use of processing software will automatically compare the terms of the payer contract with the payments received to flag any discrepancies. These alerts can let your office forecast future collection, raise your net collection numbers and improve your billing efficiency.
Rely on Data
Thanks to AI and machine learning, medical billing software can do a number of things with big data in a matter of seconds. Reporting is crucial for charting and tracking the trends in billing and collections. If you are unaware of where the problems are, you will continue to lose money and floundering in your collections process. Intuitive software can generate reports are scheduled intervals for recurring assessment, but reports can also be printed as needed. You improve your decision-making when choices are grounded in facts and figures.
Medical billing is becoming increasingly more complex, and the pressure that your staff may feel to catch the hundreds of claims slipping through the cracks is unproductive. Through the use of software, you can set up a strong support system to ensure claims are processed correctly and tracked for complete payment.