Medical billing and coding is a time-consuming process. If a patient has a complicated case or a significant medical history, billing can take anywhere from a few days to several months. There are ways to improve the billing process and increase the rate of first-pass medical claim acceptance and submission. There are several ways to improve the billing process and increase the rate of first-pass medical claim acceptance and submission.

Five Ways Of Medical Billing

1. Keep your patient files up to date

Verify that the demographics and insurance information for each patient visit is correct. If a patient changes jobs or reaches the age where they are eligible for Medicare, insurance carriers and coverage limits can be adjusted. Medical claims processing requires confirmation of the coinsurance percentage and policy number, as well as verification of the insurance company’s billing address and subscriber information. The policy number matches the record of the third-party payer.

2. Prepare to Succeed

Every insurance company has its own set of rules. That is why training programs are required to ensure that every carrier has all of the necessary information to expedite the processing of medical claims following a request and that payment departments have efficient access to patient files and filing specifications.

3. Monitor Denials

Your medical claims billing process should be used to keep track of your denials. With each rejected claim, you gain insight into what might be wrong with your approach. If your denial rate appears to be unusually high, your employees may need additional training. It’s also possible that your scrubbing is insufficient. If you keep track of your denials, you’ll be able to figure out what steps your practice should take.

4. General reasons for denial include

  • Doctors are not properly qualified
  • You might not have enough supporting documentation.
  • Your team employs codes for services or software that aren’t covered by carriers’ protection.

Simple steps can be taken by the practice to increase productivity in monitoring denial codes. It can, for example, save time and improve accuracy when submitting chart notes to the billing department and billing codes on a daily basis. Similarly, if claims for “non-covered” services are repeatedly rejected, it may be time to revisit the verification process and coding protocol.

5. Outsource the most difficult collections

For several years, you and your fellow stakeholders may have refused to consider outsourcing work as a community service. However, keeping an open mind is especially important when the quality of your output is at stake. Working with a third-party revenue cycle management firm frees up employees while experts handle the most difficult collections. They are compassionate and sensitive when it comes to assisting patients with unpaid charges, such as setting up a payment plan. Your staff can no longer bear the brunt of angry patients who are unable to pay their bills.