Is your medical practice suffering due to delayed or stagnant revenue collection?
You are not alone.
One of the biggest challenges facing medical professionals and hospitals is simply getting paid. Even with drastic improvements in technology, medical billing remains a complicated and long-drawn out procedure. Inept handling of the billing process can result in mounting medical debt for patients and lead to loss of thousands of dollars in revenue for medical practices and hospitals.
Top Reasons for Delays in Revenue Collection at Medical Practices
Before we dive into the solution for improving medical billing at medical practices and hospitals, here is a brief look at the inherent problems that lead to delays in revenue collection.
Difficulty in collecting payments once the patient has left the facility - While co-pays assure hospitals and physician offices of a down payment, collecting the remainder of the patient's bill becomes a struggle, especially when patients receive incorrect bills or bills with larger amounts than anticipated.
Not auto-checking coverage - Patients aren't always knowledgeable about their insurance coverage. Not checking insurance coverage electronically can lead to serious revenue losses and billing headaches for hospitals and physician offices.
Conducting procedures that are not preauthorized - Approving procedures that aren't covered or require pre-authorization can trigger an onset of issues when the bill is sent to the insurer.
Not using the correct codes - Medical billing codes are updated and rewritten regularly. Not updating the billing software with the current codes can lead to unwarranted delays in revenue collection.
Lack of trained staff - Untrained or under-trained staff pose a significant challenge in the revenue collection process. Use of wrong codes, incorrect capture of a patient's demographic information, and other errors in clinical documentation can cause a loss of revenue.
Not investing in technology - Lack of automated systems to capture and process patient information (often at smaller private practices and physician offices) can cause a substantial amount of income to be lost.
Benefits of Outsourcing Medical Billing
Done correctly, outsourcing medical billing can free your time so you and your staff can focus on core hospital and physician office functions, reduce the billing uncertainties facing your patients, and significantly improve your revenue collections.
Here are the benefits of outsourcing your revenue collections:
1. Lower overheads - One of the more obvious benefits of working with the experienced billing partner is a lowering of overhead expenses. You no longer need to worry about hiring and training staff specifically to handle the billing. Also, you don't have to invest in procuring and upgrading expensive billing software. Since billing vendors perform medical billings en masse, they benefit from economies of scale, which means you can actually use their services at reasonable price plans.
2. Get paid faster - The average revenue cycle time has a significant bearing on the bottom line. A dedicated medical billing team has the expertise to detect potential denials upfront and rework the claims for timely clearance by the insurer. A professional billing service will further reduce the claim turnaround time by ensuring that all claims are transmitted electronically. Plus, you don’t have to worry about delays in claim processing when an in-house employee decides to take a day-off or when you have a change in staff.
3. Access to the latest changes - Keeping up with the changing rules and regulations of medical practices can be time consuming. When you work with a dedicated billing company you are kept informed of the changes in government regulations on billing. You also gain access to industry billing trends aggregated by the biller from a network of other practices. Staying up to date on the latest changes in regulations also means better compliance and fewer rejections in claims.
4. Greater information security - When you have in-house billing, system security is a major concern. Upgrading your software to protect against malicious ransomware and hackers can cost loads of dollars. On the other hand, when you outsource medical billing, this additional task is taken care of by the biller. When a HIPAA compliant billing company is chosen, you won't need to worry about the confidentiality of patient information shared with a third-party.
5. Greater patient satisfaction - When you don't have to spend time training billing staff, ensuring information security of patient data, following up with the insurer on claims, or keeping up with changes in regulations and coding requirements, you have that much more time to focus on patient care. Improved patient experiences will translate to patient loyalty as well as the willingness of patients to refer your practice to others.
6. Greater control - Some medical practitioners fear that outsourcing will lead to loss of control on revenue collection. When in fact, the situation is quite the opposite. With a professional medical billing company, you are assured of a dedicated team of specialists who scrutinize each claim to minimize chances of rejection. With all claims being submitted electronically, there is greater tracking on turnaround times and revenue. It also becomes much easier to identify any internal lapses in collecting patient information and upfront payments.
Although outsourcing medical billing is not a new concept, in the ever-changing world of medical billing rules, regulations, and technologies, the revenue collection benefits of working with the right medical billing partner, are only amplified. But how do you know if it's the right time to outsource medical billing for your private practice or hospital?
For that, you must assess the following:
- Have your revenue collections been dropping?
- Is your revenue collection taking longer than before?
- Do you have staffing problems such as lack of training or high employee turnover?
- Are you struggling with finding finances to invest in the latest practice management technologies?
- Would you rather focus on your practice than deal with the challenges of in-house billing?
- Are you a new medical provider? (Outsourcing can provide relief from day to day management of payments so you can focus on building your practice)
- Are you currently dealing with multiple software systems for your billing process, or are you unhappy with the time it currently takes to confirm patient eligibility on existing systems?
If you have answered 'Yes' to any of the above questions, it's time to approach an experienced billing service to boost your revenue collection.
PracticeForces has proven expertise in boosting revenue collection in medical practices through an innovative and aggressive follow-up approach using the latest technologies, robotics, and trained human capital. The medical billing services we offer include:
- Eligibility verification: Real-time status with estimated patient portion balance.
- Precertification: Procuring authorizations and referrals using online tools and scanning them into the billing system.
- Authorizations: Making sure you have authorization in place for every procedure.
- Charge Creation and Review: EMR system to generate charges.
- Coding and Auditing: Checking claims coding and making changes if required
- Claims submission: Automated claim submission using a built-in clearinghouse. Electronic transmission of claims within 12 hours of patient visit.
- Denial follow up: Using robotics to identify exclusions, make corrections and resubmit.
- Patient collections: Automate patient credit card collections within the system to charge the patient when deductibles , copays or coinsurances are due.
- Insurance follow-ups: A dedicated expert team for reviewing different scenarios and aggressively chasing denials.
- Direct deposit to your bank: ACH transfer of patient and insurance checks to your bank account and daily reconciliation of deposits.