9 Proactive Medical Billing Tips To Maximize Revenue

Let’s face it: changes in the healthcare system have brought a set of new challenges for providers and patients alike. Many elements of healthcare reform, such as the rollout of more burdensome compensation models and the daily changes to billing rules and regulations, tend to cause revenue deficiencies for providers everywhere.

Medical providers in the United States leave approximately $125 billion in uncollected revenue on the table annually due to a lack of staying current on medical billing rules and regulations, along with medical billing errors.

To ensure you can provide the best care for your patients, it’s important for your practice to generate revenue. Improving your medical billing processes can help you achieve this without compromising on patient care. Here are nine practical tips to enhance your revenue cycle.

1. Provide staff with appropriate facts

To know what to collect, the first step is developing fee schedules for common office visits, testing, and some medical procedures for your most significant contracted insurance plans plus Medicare. Place this information out in tabular format so that staff can quickly determine what a patient owes if they haven’t met their deductible.

2. Establish a clear collections process

This being said, all providers must have some form of collection process in place to maintain the financial health of their practice. In many cases, developing a step-by-step approach will outline the procedures for all involved and thus greatly enhance the healthcare revenue cycle by better preparing patients and informing them of their responsibilities, which brings us to our next step.

3. Ensure patient financial responsibility is known

Medical practices have to capture healthcare revenue cycle upfront during the patient’s point of contact to decrease the time utilized in the follow-up of patients and also to speed up the times of patient payments. While healthcare consumers increasingly bear more financial responsibility for their healthcare services, effective communication is necessary to educate patients about their financial responsibilities at the time of care.

4. Manage claims effectively

An estimated 80 percent of all medical bills have errors, and due to the strict rules insurance companies have concerning correct billing, they most likely get rejected. The submission, rejection, editing, and resubmission cycle can take several weeks, often leaving providers to wait for months before receiving the payments for their work.

For this reason, it is very important that the claim be complete and accurate the first time because so much time and effort are lost in the resubmission of claims. This means that the information must be inputted correctly, and the claims should be double-checked for any possible error beforehand.

5. Train the front desk staff on requesting money

One might hear the front desk staff say, “Are you going to pay your copay today?” or “I’m sorry, but I have to ask you to pay today.” Training and role-playing are critical to creating staff self-assurance about requesting money. Offer scripts that help staff cope with complaints and delicate matters, such as what to do when a patient can’t pay.

6. Collect pre-procedure deposits

Some practices have instituted the habit of providing a written estimate to patients regarding what they will owe for procedures, etc. Online cost estimators set up by many payers project the patient’s out-of-pocket obligation based on unmet deductibles, non-covered services, and co-insurance.

7. Offer multiple payment options

We have been getting a number of patients inquiring if they can set up an “auto pay” with their credit card to pay off a balance. Another option that has become popular for those patients with $1,500+ deductibles when they no longer have credit card rooms is patient financing.

The usual case is that the practice is paid a minor service fee while the balance is paid in full and off the A/R—no more statements and staff phone calls. Moreover, online pay is an opportunity to encourage patients to pay past-due balances.

8. Offer a discount if you pay in full

In order to collect large, overdue balances, an experienced staff member should speak with the patient to discuss various payment options, including a discount if the patient agrees to pay the balance in full.

9. Have a plan for financial hardship

Obviously, there are going to be patients who simply don’t have the money to pay their bills—rather than allowing that money to languish in the A/R, provide aid to patients who meet specific stipulations, such as household income that is a certain percentage above the U.S. Poverty Guidelines.

Think about conducting a hospital’s approach to a sliding payment scale. And for those patients who are indigent and just plain unable to pay, do not delay. Advance a process for “charity care” instead of allowing the account to inflate your A/R.

Conclusion

Wrapping up, medical billing is one of the significant facilitators that can actually take your practice’s financial success to the next level.

Outsourcing a medical billing company isn’t an option; instead, it needs to be done to keep pace with challenges in the healthcare system. It will reduce claim denials and enhance your revenue cycle. Many outsourcing companies offer a free trial of the service option. This will no doubt help to evaluate service quality and turnaround time.