The federal government has brought about a lot of changes in the US healthcare system since the past few years. These changes have introduced a lot of challenges for providers and patients alike. Many aspects of healthcare reform including; the introduction of more time-consuming, value-based compensation models and the frequent alterations to hospital medical billing rules and regulations can cause a significant range of revenue loss for providers across the United States.
Therefore, if providers fail to stay up-to-date on hospital billing rules and regulations result in providers leaving approximately $125 billion in uncollected revenue each year. Specialty practitioners like radiologists face even greater difficulties due to the complexity of their billing procedures.
Simultaneously, patients can’t afford increasingly expensive healthcare services due to high-deductible plans. Therefore, hospitals should partner with a reliable hospital billing company that can help them guide them strategies to help them encounter these challenges.
How can a hospital billing company help you over hurdles?
Let’s paint a dismal picture of the financial health of the industry with authentic data paints. It would help providers to analyze their reimbursement models and mitigate practice financial issues and compliance risks. In this article, I have enlisted 6 proactive ways that can help providers to take a proactive approach to maximize their revenue generation.
1. Prepare a Clear Collections Process
All practices require a collection process to ensure the financial health of their medical business. They should establish a step-by-step procedure that clarifies the procedure for all. It can greatly improve revenue cycles by ensuring patients are properly and thoroughly aware of their responsibilities.
2. Focus on Claim Management Properly
According to a recent study, 80% of claims are rejected due to errors yearly. Due to the strict policies of insurance companies about accurate medical billing and coding practices, they are likely going to end up being rejected. Therefore, practitioners should prepare claim management that focuses on streamlining each step with 100% focus on the cycle of submission, rejection, editing and resubmission can take weeks. It often results in providers waiting for months prior to receiving payment for their services.
3. Minimize Coding Errors
Medical coders describe the performed medical procedures within a claim using standardized medical codes. It makes the claims easy to understand and proceed for further levels. These codes can use ICD-10_CM, CPT and HCPCS Level II classification systems. This process provides a standard method of describing procedures. However, a hospital billing specialist can ensure that the claim is prepared with less or no error. So it can be reimbursed for the first time without wasting the times and efforts of the whole team. Most importantly, if you partner with a reliable hospital billing company then their certified employees can ensure that your claims are not filed with out-to-date, mismatched, incorrect or missing codes. Because when these mistakes are identified by the clearinghouses then they deny such erroneous claims before they can become an issue for payers.
4. Promptly Follow-up on Denied or Rejected Claims
Before diving into details, let’s establish the difference between a rejected claim and a denied claim.
Rejected Claim: A rejected claim is one that hasn’t been processed yet due to the existence of one or more errors. It hinders the insurance company from paying the bills as it is written.
Denied Claim: A denied claim is a claim that the insurance company has processed and has considered unplayable due to the discovery of a violation of the payer- patient contract or due to the identification of vital errors caught after processing the claim.
In both of these scenarios, the payer will return the claim to the biller without paying any amount with an explanation of the problem. If you have the best hospital billing company on your side then you can rectify and resubmit your claims. But remember that a denied claim is appealed prior to resubmission. Consequently, it is a much more costly and time-consuming process.
Therefore, it is essential to check for errors in a claim to minimize the occurrence of rejections and denials. However, if such errors occur then make sure that they are handled as quickly as possible. Here comes the profitable aspect of a dedicated hospital billing company that consistently keeps in touch with the representatives of the payer.
Hence, they can help clarify problems with the original claims and provide information on current claims as they are processed. All of these endeavours would result in the expedition of the claim editing process, minimize appeals and resubmission times. Hence, it would save your practice sufficient time so you can invest your time and efforts in providing quality care services.
5. Improve Operational Capabilities
The healthcare field is constantly changing, therefore, hospitals should follow suits to maximize their efficiency and revenue. A hospital billing company can save your administration time by providing analytical reports and guidelines to comply with the latest healthcare regulations. Hence, medical staff at hospitals can identify key areas that are causing problems and demand new strategies to address those problems.
6. Partner with a Reliable Medical Billing Company
Medical practices must constantly deliver quality care services and comply with current trends in medicine and proper staff management. They must also stay current with the most recent rules about medical coding protocols, insurance companies and medical billing regulations. With so much depth to comply with, an already busy medical staff can slip through the cracks that can lead to rejections, denials, and underpayments that make medical practices to invest their important time and money in the administration procedures.
Along with their insider’s view or in-depth knowledge, a hospital billing company can implement billing procedures and use smart software solutions and equipment to help providers stand out. This can help you manage challenges that arise due to the costly time and labour involved in monitoring down debtors, submitting and editing claims. In this way, it’s an effective way to increase revenue and regain control over your hospital billing department.
If you are looking for the best hospital billing company that can help you achieve your success with fast and reliable collection management, then outsource hospital billing services to medical billing companies, Learn more! We provide the best medical billing services and help you run the business more efficiently!