Protecting Your Bottom Line: 6 Strategies for Accurate Medical Billing

Correct medical billing is the foundation of any healthcare practice. It is the thing that allows it to exist as a standalone entity. When executed poorly, it can cause claims to be delayed, or denied, and generally create a bigger headache than it should.

That is why we have listed out several simple yet effective steps to optimize the existing process and protect the financial health of a practice.

1. Know Your Codes Inside and Out

Medical coding is the language of billing. Medical coding, well, is the language of billing. Every procedure, diagnosis, and service has a unique code. If you use the wrong code, your claim could be denied or you might get paid less.

Take the Time: Make sure your billing staff is properly trained. Ensure they’re aware of the latest coding changes and guidelines.

Double-check: Never submit claims without getting a fresh pair of eyes to look them over first. This will ensure that no errors which could lead to trouble down the line, get through.

2. Get It Right the First Time: Clean Claims Are Key

A “clean claim” has all the necessary information and is free of errors. They are processed more quickly and are less likely to be denied.

Essential Elements: Make sure every claim has the patient’s name and contact information, insurance information, the date of service, and the right codes for the service.

Software can help. Medical billing software can automate much of the process. This reduces some human errors and gets the claim where it needs to go more quickly.

3. Stay on Top of Claim Denials

Denied claims are undoubtedly frustrating, but even with all care, some claims will be denied. The thing is to handle denials promptly and efficiently. Here are some tips:

Understand Why: Every time a claim gets denied, look for reasons and try to understand them. Sometimes it is an easy-to-fix problem, such as the wrong code, or missing information but sometimes the issue lies in the insurance company’s policies or practices and will require you not to work with them in the future.

Appeal Process: Always appeal a denial if you have any inkling of doubt as most of the denied claims get overturned during the appeals process.

4. Verify Insurance Eligibility Upfront

Check a patient’s insurance status before you provide any services. This simple step can save you many problems later.

Check the Details: Confirm that the patient’s insurance policy is active and can be used for the service you will give.
Get Preauthorization: Some services require preauthorization from the insurance company to make sure they will pay for them.

5. Communicate Clearly with Patients

Communication with patients is very important for the proper process of medical billing. The following areas can contribute significantly to the adequate communication with the patients:

Explain Costs: This approach requires communicating to patients what costs will result from their care. Patients should be adequately informed about the financial burden they might have. This will contribute to avoiding further disputes in the billing.

Financial Policy: It is also important to have an adequate financial policy clearly stated to the patients. This policy should inform patients about the payment expectations, bill process, and collection procedures. Clear communication and explanation of financial policy will help to make patients understand what to expect and prevent misunderstandings.

6. Regularly Review Your Billing Processes

Medical billing isn’t a “set it and forget it” kind of thing. The healthcare industry is constantly changing, with new regulations, codes, and insurance policies coming out all the time.

Stay Updated: Make sure you are well informed about the changes going on in the industry. You could consider joining some health-care or medicine-based organizations and attending conferences.

Internal Audits: Do this regularly. You will be surprised at all the trends you will pick up on. Doing this might be your best chance at early error detection. It will also help you assess and define your efficiency level.

These simple and effective strategies can help you take control of your medical billing, eliminate mistakes, and ensure that you receive timely payments for your services. Remember that proper medical billing is not only a matter of getting paid, but it is also about protecting your bottom line and safeguarding the financial future of your practice.

Struggling with medical billing? Capline specializes in helping healthcare providers like you navigate the complexities of coding, claims, and insurance. Let us handle the paperwork so you can focus on patient care. Contact us for a free consultation and see how we can improve your revenue cycle.