There’s no denying that small private practices have taken a financial hit on account of the crushing effects of Covid-19 pandemic. Insufficient reimbursements for services and a lack of flexibility in billing rules that affect reimbursement amounts have made them hard to stay afloat. Gone are the days of submitting a medical claim and getting paid within a 30-day window frame. The relaxed billing guidelines and revised reimbursement policies that were put in place during the Public Health Emergency (PHE) made it extremely challenging to collect accurate insurance reimbursements. With the practice’s claim denial rates increasing and patient payments reducing, detracted physicians from focusing on patient care and spending significantly more time on complex billing activities. Let us in this blog discuss some of the ways in which you can improve your practice collection and ensure a healthy revenue cycle this year.
Ensure accurate patient data and insurance information
Having complete and up-to-date patient information is the first step to improving revenue collections. It is observed that incorrect demographic patient data and insurance information is one of the common reasons for claim rejections. Medical practices lose up to 30% of revenue due to inefficient billing processes and claim denials. Well, what could be done? When a patient calls the front office to schedule an appointment it is important that they collect accurate and current information. Patient demographics and insurance details should be crosschecked against the payer database. Additionally, you can also verify the correctness of patient data and insurance coverage by visiting provider portals.
Collect payments at the time of service
Most medical practices tend to overlook patient balances. With insurance carriers covering the majority of payments practices weren’t so keen on collecting payments from patients. But the rapid growth of high deductible health plans resulted in out-of-the-pocket costs. With most of the patients having a deductible of at least $1,000, a practice cannot afford to leave that money on the table. What could be done? Well, make sure to confirm patient’s eligibility and verify insurance benefits prior to the appointment itself. It is not appropriate to send the statement and wait endlessly for the payment. Patients should know their financial obligations to avoid any surprises. Failing to do so spells collection issues. Hence, it is important that your front desk staff communicates and makes them understand their financial responsibility and collect the payment at the point of service.
Improvise on coding accuracy
ICD 11 is officially released for implementation and will replace ICD 10 in the billing industry. The switch to ICD-10 resulted in the introduction of more than 140,000 new procedural and diagnostic codes, so the next transition will be even more. In fact, ICD-11 contains nearly 4x as many codes as ICD-10. It will include procedures and tests for identifying or treating COVID-19. All of this simply means that there is a possibility to either undercode or upcode or even omit or swap codes, resulting in claim denials. In the case of small private practices, it is the provider who assigns codes and submits claims. They hardly have the time to focus on coding and there is always a chance of assigning wrong codes or miss assigning charges for services rendered. It is best that they let coding professionals handle their medical coding and auditing needs.
Outsource billing needs
It is difficult for small private practice physicians to focus on providing quality patient care amidst billing patients and collecting payments. On the other side, when they don’t concentrate on medical billing, they will lose millions of dollars due to improper billing. So what could be done? Well, partnering with a reputed medical billing service provider is the best option. They have an experienced billing team who knows about the latest rules on medical coding standards, medical billing regulations, and changes in the payer reimbursement policies to ensure quick and accurate collection of payments.
If you are an independent practitioner juggling practice collections and caring for the sick, we are here to help you. Scribe4Me’s medical billing services can help improve collections and cash flow for your practice. To know more about our billing and coding services, get in touch with us today.
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