Getting your practice running better-Improving Healthcare collections

Posted by Ecareindia on June 24th, 2011

If I say this, it would give a better meaning if I mention about improving the medical billing collections. In the United States, healthcare industry functions in a totally different way. Practices not only have to care about curing the patients and coping with technology and medical advancements, but also have to run behind the uncollected money. It is unfair but has become an essential part of the day-day operations of any practice. So, how do we go about this?

All that we can do is organizing the operations where medical billing is concerned so that it can give practices a better tomorrow. At the same time, we know that optimizing the revenue flow is a tough game and most importantly a time consuming job. But we don’t have an option. It is essential to make good the loss when it comes to money. Once you streamline the process and make it a practice, you will not have to spend enormous time and human resource in working with collection backlog.

It starts here – Medical Billing 

Patient Demographics:

Collecting all possible relevant and mandatory information from the patients is essential. Moreover the information should be accurate since the base for errors with medical billing is patient information. Executives at the doctor’s front office who collect and manage the patient information should make sure that the information collected is correct to avoid delays and reworks. Organizations can be twice as profitable as they are currently when they avoid or eliminate reworks and delays.

Insurance Eligibility Verification:

Patients might give card-copies which are not effective or which does not cover the service at the time of appointment.   Before filing a claim it is advisable to check and confirm the Patient's eligibility with the Insurance so that we do not end up in denials. Researches prove that improper verification of insurance can increase claim denials. So, it is necessary that insurance verification should be done well before starting the process.  

Medical Coding & Charge Entry: Sending clean claims

It is a little crucial when handling claims at this stage. Application of proper procedure codes, modifiers and state specific rules is inevitable. More over charges have to be entered accurately and double billing has to be eliminated. Making errors at this stage can be risky and would consume time and work in error analysis and rectification, causing delays and even denials. Not to miss, giving attention to claims filing limit. All these factors have strong influence on the reimbursement of the claims.

All we need is maximum reimbursement for the claims. In that case, we need to double check for errors and eliminate them before the claim reaches the insurance carrier or the clearing house. When sending clean claims and in appropriate format, it is assured that the claim would be reimbursed.

Accounts receivable & Follow up:

Doing regular follow ups can improve relation with the insurance carrier and would inculcate precision in the daily operations while speeding up the process. Analyzing the aged AR and working on a plan to get the claim reimbursed would boost your collections. But prioritizing the claims is even more vital. When you have an old AR and a high value claim at your desk, giving importance to the high value claim would be the best deal – that is act to situation. 

Giving importance To Patient AR:

Patient AR also forms a significant part of the total collections. Therefore collecting money from the patients should also be given necessary attention and we have to follow systematic approach towards money collection. Collecting money from patients is easier when the follow-up is regular and the approach is professional. Most of the patients pay up within a few follow ups.

Handling Denials:

Denial analysis is a little exhausting but effective part. We call it the root cause analysis, when the denied claim is completely examined for flaws. Once rectification is done, care should be taken that the reworked claims should immediately be transmitted to the insurance carrier. Delays can minimize the chance of getting the claims reimbursed. 

At last, it is Staying updated with the industry:

While staying updated with the industry, we will know the latest changes in policies, regulations and procedures which will help us in eliminating the errors occurring due to ignorance, costing huge dollars. Increasing medical billing collections is all about following the procedures and acting smart to the situation. It is nothing but a combination of certain factors: efficient medical billing software, talented work force and streamlined process- compliance, along with Regular follow-ups and eliminated errors guaranteeing you increased medical billing collections.

About The Author:

Tanya Gill is the Public Relations Manager for ecare India based in Chennai, India. She has wide knowledge and experience in the medical industry. ecare India is an ISO 9001:2008 and the first Indian medical billing company to obtain ISO 27001:2005 certification is a healthcare outsourcing service company providing solutions for all your medical billing needs along with a wide range of services helping you to achieve incremental revenues with reduced costs.

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Joined: June 20th, 2011
Articles Posted: 88

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