How can Medical providers overcome billing challenges?

The medical billing process has never been easy due to a range of factors like patient cooperation, rates and standards,  claims, forms, payments, and overhaul codes. As a healthcare provider, how prepared you are for  the challenges largely affect your revenue cycle. 

Here are the challenges medical providers need to overcome and improve the  medical billing process. 

Staff training for collecting full copays:
Studies show that open and transparent communication with patients can help the provider in getting payment on-time. Copays are down payments collected by the provider for the rendered services. It is highly commendable to collect copays and any amount at the time of service, as the chances of collecting the same go down as soon as the patient leaves the premises. Skilled staff offering multiple payment  options such as credit card payments, online payments can support timely collections before the patient’s first visit. Providing training to your employee about the practice’s policy for the upfront collection  can avoid recurring losses. For out-of-pocket expenses, keeping your patients informed of the  portion he/she is responsible for can boost your revenue cycle. Instead of waiving unaffordable copays,  enhance the collection process. Let’s say an average copay of $25 for an average of 12 patients in a  day per practitioner, that is $300 in copays per patient. If the provider’s office is open 200 days a year, it can bring in a total of $60,000 copay collection in a year. With the correct staff training,  you can safeguard a positive cash flow. 

Adopting automate insurance coverage: 

Keep a tab and carry out regular checking of patient’s coverage before their visit. Moreover, the administrator’s personalized service of eligibility verification can prevent billing issues and inconsistent cash flow. Automating insurance coverage can be used as a standard treatment protocol to expedite claim processing. 

Track prior approvals or pre-authorizations: 

Medical billing is time-consuming when governed by a set of rules, leaving scope for mistakes. Instead of your patients being surprised by an out-of-pocket expense, be sure to inform them about  the high-cost procedure. For one, you do not have to worry about RCM. Second, the patient is  priorly informed about their portion of the treatment. Sometimes the patient upgrades to the expensive plan & lower deductibles. Thinking that the insurer will make the payment, but then they get surprised by an unexpectedly higher bill. As a provider, you can save time, energy, and cash flow disruptions by tracking and getting prior approvals of all changes and adjustments so that the cost is as per the expectations of both the insurance providers as well as the patients. 

Billing and coding: 

Technology is constantly changing. Tasks like selecting the correct medical billing codes with new procedures can keep your practice smooth. It demands extreme caution as codes with newly defined  areas of treatment can directly affect your practice income. Therefore, it is important to avoid denials, review and  note the changes for coding. One can also get in touch with billing and coding experts to ensure a designated amount of cash  flow is coming to the office. 

Improve over-billing challenges: 

Over-billing appears as an intentional tactic to mess up the practice to obtain higher payments. This is why it is necessary to cut down on overbilling. 

Automated System:
Busy practices with limited staff members create billing blemishes, especially  with the manual billing process. Automating billing functions serve the office task well and also  improve claim adjudication services without dragging additional support.

Track Denials: 

As a provider, you can save a lot of revenue while adhering to the guidelines  established by the government and the insurer. Failure to obtain can result in denied claims and  higher A/R days. You can start with managing the process guidelines for effective revenue cycle management. 

Absence of supporting solutions:
Nothing is more frustrating than kicked-back claims. With the  appropriate documents submitted electronically, track the process of the insurance claim for quicker  reimbursement. By adopting the latest tools, you can bring visibility to the claim process. 

As a provider, you can address many billing challenges that are completely in your hand. Thereby, being  diligent on your part and collaboration with medical billing experts can address shortcomings with a  positive cash flow, eventually boosting your RCM.