Improving You Medical Billing
The billing process is a key component of a medical practice’s success, as well as it profits. However, the increase in high-deductible plans as well as the implementation of the ICD-10 coding process has left healthcare providers with a number of challenges in their billing processes.
Although the denial rate for claims has not differed significantly since its implementation, the amount of claims still being denied, combined with the penalties incurred under the audit. With over 12 billion in claims denied since the ICD-10, and an average of 1 in 5 claims still being delayed or denied, a hospital or health system can experience as much as a 3 percent decrease in their revenue stream.
The solution to reducing the chances of claim denial, as well as avoiding penalties from non-compliance of ICD-10, is in the billing process. An effective medical billing system will allow you to optimize your revenue cycle management as well as reduce time in accounts receivable.
Accurate Patient Information
The billing process begins with the patient’s information. In addition to the patient’s demographic information, it is vital to obtain the most recent and accurate insurance information, and determine their eligibility prior to treatment. Denials and rejections most often occur because a patient is not eligible under their current insurance plan, and obtaining the most accurate and up-to-date information from each patient on a regular basis can help to avoid problems with future claims.
Determine Patient’s Financial Responsibility
Healthcare has undergone a number of changes, including an increase in patient responsibility for services provided. High-Deductible plans are common, however, a report from McKinsey & Company found that providers expect to collect only 50 to 70 percent of their patient’s balance following a visit. Implementing solutions that estimate a patient’s balance as well as simplifying their bills to make them easier to understand can help to reduce the number of accounts in collections.
Streamline the claims management process
The claims process can be a lengthy and often complex one, from submission to collection of payment. The burden is often on the administration staff, many of whom don’t have the time or the training to navigate this process efficiently. An automated system can help to improve performance as well as provide necessary data that can help streamline the process.
Know the coding
Some of the most common errors in medical billing are the result of improperly coding procedures. With the ICD-10 implementation, inaccurate coding can not only lead to rejection of claims, it can lead to fines in the case of an audit. To understand the coding process and perform it accurately, it is necessary to provide ongoing training on the current coding procedures.
Main Street Medical Consulting can help you manage your revenue cycle management with our expert consulting services. Our medical billing and consulting services have been used across Pittsburgh and the Tri-State area by both medical practices and regional hospitals. Our team can help your practice to become not only more efficient, but compliant, utilizing state-of-the-art technology that will help you to increase your profits and decrease your claim denials. Whether you are a private practice or a hospital-managed medical facility, Main Street Medical Consulting has a medical billing solution to meet your needs. Contact our team today for more information.