Medical billing and coding are complex but necessary tasks that require a great deal of attention and skill. Doing it incorrectly or without thoroughness can cause problems for the physician and the patient. Fortunately, you can take steps to ensure your medical billings are successful and accurate. Here are some ways to get started.
Patient Check-In Process
Patient check-in is the first stage of every patient’s appointment and the medical billing process. Retrieve as much information about your patients as possible. This should include home and mailing addresses, phone numbers, email, occupation, workplace, and a copy of your patient’s photo ID. This information is crucial for the medical billing and coding process and may become necessary for a collection agency down the line.
With returning patients, always verify their mailing addresses and other contact information. Missing or incorrect information is one of the most common reasons for rejected or denied claims. Also, be sure to get your patient’s permission to leave messages on their phone, so you can remind them of appointments and upcoming payments. To be compliant with HIPPA, Always keep patient information in a secure location and system. A solid patient check-in process is the first step to ensuring a successful medical billing process.
Verify Insurance Eligibility
Insurance eligibility is another common reason for rejected or denied claims. Failure to verify a patient’s insurance can prevent successful medical billing. Be sure to collect the patient’s insurance card and information before the appointment to avoid claim denials. This includes a copy of their insurance card, insurance company, policy ID number, name of payer, and group number, if applicable.
An automated verification system can help you save on labor costs and free up your front office staff to make appointments and assist patients. Verifying insurance is not just for new patients, you should always verify the insurance of returning patients as well. Making sure that your patients are insured before treatment will contribute to a successful medical billing process.
Establish a Clear Collections Process
The medical billing process centers on ensuring the financial viability of your practice. A clear collections process starts with explaining the terms to patients. Use your new patient forms to establish what is expected of them regarding their bill. Also, regularly remind returning patients of your collections policy, particularly if there are changes. Explain to patients what payment options, including payment plans if your practice offers them.
Your collection process should include a written step-by-step approach that clarifies the procedure for all parties involved. This can improve your practice’s revenue by ensuring that all payers are informed of their financial obligations.
Manage Claims Properly
Insurance companies are very strict when it comes to medical billing and coding. The billing process can take weeks and even months, including submission, rejection, and resubmission. Submitting claims accurately and completely the first time is the goal for every claim. Always double-check claims before filing them to ensure accuracy.
Rejected and denied claims are very common, so a process for managing these is essential for a successful medical billing process. A rejected claim has not been processed due to the discovery of errors in the claim. This prevents the insurance company from paying the bill as written, but the biller can correct and resubmit the claim. On the other hand, a denied claim is a claim that the insurance company has processed and deemed un-payable. This could be for any reason, from violating the patient-payer contract to missing information. Denied claims cannot be edited unless they are appealed.
Minimize Coding Errors
The American Medical Association creates guidelines for medical coders. Medical coding uses the standardized guidelines of Current Procedural Terminology (CPT) and the Healthcare Common Procedure Coding System (HCPCS). A clear understanding of these systems is essential for having a successful medical billing process. These code modifiers provide information about the procedures the patient received. Even with standardized processes, errors still occur. The most common coding error includes incorrect or missing codes and non-specific diagnosis codes.
Outsource Medical Billing and Coding
Medical billing and coding are extremely complicated and may put a strain on your staff. Outsourcing offers dedicated specialists whose whole job is ensuring timely and accurate claims are filed. These specialists also stay up-to-date on new regulations and rules for billing and coding. Outsourcing your medical billing and coding process allows you to focus on delivering the best patient care.
How Can Medbillytics Help You?
You may have been recommended to us by one of our many satisfied customers, or you may have searched online for “medical billing services near me.” However you found us, we’re happy to welcome you. Let Medbillytics help with your healthcare practice’s credibility and reputation. Reach out to learn more about all our services today!