The success of your healthcare facility largely depends on the efficiency of the organizational elements. One of the organizational aspects you should focus on is medical billing. An efficient billing process helps keep your practice running smoothly and accountably. Your medical practice needs financial resources to deliver its services to your patients.
Here are the five best medical billing practices to help you get started:
Table of Contents
Understand the Billing Process
If you are inexperienced with the billing procedure, coming up with a solution can be challenging. Start by learning about the steps of this procedure from beginning to end. Understanding the billing process promotes the timely submission of claims and helps to prevent fraud.
The medical billing process involves:
- Verifying Insurance Eligibility: During check-in, confirm the patients’ insurance eligibility. It will help the patient be aware well in advance of which claims will be accepted by the insurer. There should be no payment surprises after a procedure.
- Collecting Copays: Insured patients are typically responsible for paying a part of their medical bill. Their insurance pays the rest. From the start, inform your patient about their financial responsibility.
- Sharing Diagnoses and Procedures: Healthcare facilities share medical codes between providers and insurers. Every diagnosis or medical procedure has a corresponding code. The provider first shares the code with the coder and then sends it to the insurer for reimbursement.
- Verifying the Code Selection: When the coder receives the code, they confirm whether the provider chose the right one. The practice of verifying medical coding helps maximize revenue.
- Entering Claims: After the provider codes the patients’ treatments and medical procedures, they are submitted to the insurer as a medical claim. You then forward the claim to the insurance company through your practice management software.
- Receiving Reimbursement: After the insurer receives your claim, they can accept or deny it. If the payer claim accepts the claim, you receive the reimbursement. If the insurer rejects the claim, your facility works to address any possible errors and resubmit the claim.
Have a Documented Collection Process
Establish a clear collection process through documentation. Make this information available to your staff and patients. You should make sure all parties understand their responsibilities after the billing process. Human resources should take new employees through the details of the collection process during hiring.
For new patients, provide clear documentation explaining the collection process. The documentation helps them know what you expect from them during and after the billing process. Post this information on your medical practice website or the company’s updates.
Create a policy outlining why the staff and patients should follow the payment collection guideline. Define the available payment options for your patients. This will help patients know that they can access treatments within their budgets.
Collect Patients’ Information During Check-In
During check-in, the first step is noting the patient’s details, including age, gender, phone number, and address. Collect the patient’s insurance-related information:
- Name of the insurance provider
- Insurance plan
Confirm that the patient’s information is correct. Incorrect details on the UB-04 and HCFA leads to rejection or denial of your claim. Update and verify the patient’s information regularly.
Set up a billing system that checks your patients’ eligibility often. Doing so before billing increases the chances of a successful medical claim.
Use the Latest Technology for Medical Billing
A suitable technology solution can help your practice maximize patients’ collections. Choose billing software with all the qualities and features that your staff requires to manage the billing process. An automated billing process helps speed up reimbursement and reduce errors.
An automated billing system lessens the need for manual data entry. It helps reduce simple errors that lead to denial of the claims. In your practice, implementing the latest technology helps streamline the billing process.
Collect Medical Payments Upfront
To maintain a smooth cash flow, staff should collect payment after billing. Do not assume all patients know their responsibility after the billing process. From the start, inform your patients what you expect from them for your services.
You should include their responsibility to pay in new-patient paperwork and update the patients’ changes in the billing procedures. If the patient has to pay a certain amount of copay according to their insurance, here are steps to help make it happen:
- Inform the patient of the copay amount expected during check-in. Request for the payment upfront but be flexible for patients who cannot pay immediately.
- Communicate with patients who cannot afford to clear their copay during their appointment. Send consistent reminders until they clear their bill.
- Send your patients their statements if necessary. Sometimes the insurer may reject the medical claim. In such a case, the payment responsibility falls on the patient. To communicate this information, send a statement to the patient detailing the amount the insurance declined to pay.
Know When To Outsource
If you are having a hard time keeping up with your billing and collection process, it might be time to outsource. A reputable medical billing company focuses on giving your patients quality healthcare services. Outsourcing and having proactive billing procedures can pay off with improved operations.
