Steps to Improve Your Medical Billing Process

medical billing process

For health care practices and businesses, the quality of care is the first priority as it should be. Patient care and how you deliver that are critical to your success.

However, it’s important that you also think about revenue because, at the end of the day, even though it’s a medical practice, it’s still a business.

How can I improve my medical billing process?

When healthcare practices refine their billing and make it efficient, they’re going to see that they can also provide better care since they can focus on that, knowing that their billing resources are being maximized.

The following are some tips to improve the medical billing process.

1Use the Right Software

The critical thing that’s going to do the most to help how you do medical billing is to ensure that you have a strong foundation. A strong foundation means choosing the right billing software.

As you’re comparing medical billing software providers, you want to look at what other customers say and get a feel for the platform’s general track record in the industry.

If you need software that will work for a specialty practice, that will, of course, narrow down your options.

You have to think about the human element of billing software. If your staff isn’t comfortable using it, or it’s generally not user-friendly, then you’re not going to get as much of a return on your investment.

The right coding and billing software can help you stop revenue leakage, and you can use the data from within the system for insights that will allow you to make strategic, numbers-driven decisions.

2Stop Billing

It might sound counterintuitive, but one of the best things you can do to improve medical billing process is to stop billing.

When you send bills post-visit, then what happens is there’s more administrative time that your staff is wasting. They could be putting that time toward value-creating tasks.

It can cost anywhere from $5 to $15 per billing statement to collect the full balance owed by a patient.

So what’s the better alternative?

When possible, ask for payment at the time of service.

You have to realize that when you wait to collect, it’s going to cause problems in your revenue cycle management.

If you’re unsure of how your patients will deal with being asked for payment at the time of service, prepare them for the change. Send out letters or emails letting them know, and post signage in your office.

3Have a Clear Process for Collections

This was briefly touched on above, but the best thing you can do for your patients and your practice is to have a clear and well-defined process for collections.

You need to inform patients about the expectations for how they deal with their obligations. Let patients know when they’re new what their responsibilities are, and eliminate any possible misunderstandings.

You need to get as much information about your patients as you can, and you should require a photo ID during their first visit because you may need this later if they become delinquent. Verify addresses too.

Your staff needs to be well-trained in what the collections process is, so they can inform patients.

4Managing Claims

Around 80% of medical bills are estimated to have errors. Insurance companies are incredibly rigid about making sure that billing and coding are absolutely correct, so even small errors lead to rejections.

Then, you’re stuck in a cycle of making corrections and resubmitting, meaning that it can take months to receive payment.

There should be a process for checking the accuracy of all claims and avoiding errors.

5Deal with Denied or Rejected Claims Quickly

There is a difference between a denied claim and one that’s rejected. A rejected claim hasn’t been processed because there are errors. A denied claim is one processed by the insurance company that they didn’t pay for whatever reason.

Either way, the payer returns the claim and provides an explanation about the issue. You can correct a rejected claim and resubmit it.

With a denied claim, you have to appeal.

Regardless, checking for errors is a good way to keep these situations from happening, but when they do arise, you should have a speedy process for dealing with them.

Maybe you assign a dedicated point person who keeps track and manages the denied and rejected claims, for example.

Finally, always be looking for ways you can improve your medical billing process. This is a continuous process if you want to ensure your billing and revenue cycles are always optimized.