Medical billing is one of the most essential aspects of your clinic operations, but for small and independent clinics, it’s often one of the most overlooked. If you notice that your revenues are declining while you’re seeing the same or more patients, or that you are not able to collect on a significant portion of your billed charges, the first step is to evaluate your billing workflows. Here are three important things your staff can do before the bill goes out to make sure you are able to collect as much of your billed charges as possible.
1: Verify insurance, then verify it again.
One of the most common reasons that a claim is rejected or denied is because of a problem with the insurance coverage or information. That could be incorrect patient demographic information (a misspelled name), or changes in coverage. In some cases, it’s as simple as correcting a minor error, for example, a missing letter or number in the patient’s insurance ID. In other cases it’s more complicated; for example, a patient that had insurance and then was laid off and is no longer covered. This is especially important to check right now as many patients are experiencing job loss as a result of coronavirus.
Even when it’s a simple error, it takes time for your medical billing staff to find out what is wrong, correct the error, and resubmit it. There are specific timeframes that payers require to get these corrections, and if you miss them you won’t get paid.
An easier and better solution is to use your medical practice management software to double-check insurance coverage, once when the patient schedules his/her appointment, then again right before the appointment. That way any errors can be identified and corrected in advance.
2: Use integrated software systems.
When you see a patient and enter information into the EHR, you need that information to transfer to the billing department quickly and easily. If you have two systems that don’t communicate, that means someone must manually pull information from the EHR and input it into medical billing software. That takes time and increases the chance of an error in data transfer.
Each day that passes without submitting a claim is potentially lost revenue, as it gets more difficult to collect from patients and payers when claims are delayed.
3: Use technology to enhance payment collections.
Once a claim has gone to the payer (or for self-pay), there may still be an outstanding balance. You can send patients a bill by mail, but studies have shown that it’s actually more effective to send them an electronic notification about bills that are due. An email and follow-up text message reminder can save your practice the cost of mailed paper bills and is more likely to elicit an immediate response from a patient. It’s also critical to have a method for online bill pay available to patients so they can easily resolve outstanding balances without the need to mail a check.
To learn more about how you can improve medical billing and collections, talk to AdvancedMD to see our integrated software solutions for small and independent practices.