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Improve Your Medical Claims Billing Process

Today, the medical billing process has become so complex that it is surprisingly common for bills to not just take a few days but even months to get finalized when patients have a significant medical history or present with a complicated case.

There are a lot of ways in which your organization can vastly improve the billing and coding process, leading to speedier submission times and a definite boost to all your first-pass approval statistics.

Here are 3 sure shot ways to drastically improve the billing process for your organization’s medical claims, starting right from today:

Always Keep The Patient Files Updated

As any decent medical billing company in the United States will tell you: you will always need precise details on each of your patients. Without these details, how are you supposed to handle claims billing with any accuracy at all? Your staff will even need to verify every patient’s demographics as well as information on their insurance in each visit. This diligence will help you keep track, especially if your patient changes jobs or changes their insurance carrier, or makes any other change during the billing period.

Instead of having your patients be surprised by an unexpectedly high bill, make sure you explain the process as you go on updating their details. Mundane yet crucial details, such as the policy number, subscriber information should always be double-checked.

Keep a Track of Denials

It doesn’t matter if a practice relies on a coding vendor and an external billing or chooses to process claims internally, it is amply clear that having a straightforward system of checks and balances in place will always help improve first-pass rates.

Better than berating employees for making errors, you should change your attitude of taking every rejection as a learning opportunity to further improve the process. There could be a lot of reasons for denials, such as physicians not properly credentialed, and lack of sufficient support documentation, amongst other things.

As part of your responsibilities whole providing medical billing services in the USA you can send chart notes along with the billing codes to the billing department daily; it could save a lot of time and improve your accuracy,. Or, in case your claims get consistently returned for services that deemed “non-covered,” then you may feel the need to review the process for verifying both coverage and your coding protocols.

Delinquent Claims? Take a Follow Up!

If you really want to provide medical billing solutions in the US, one of the first steps should be dedicatedly assigning at least one staff member to review account aging, in order to determine which of the claims are not being paid on time.

After having thoroughly reviewed aged accounts receivable, you might detect communication issues with either the insurance carriers or the patients. The questions that would arise then are: have the delinquencies been caused by billing errors? Have your statements been easy for patients to understand? Has the billing and coding vendor been working on your claims as fast as you need?

You will need to consistently review delinquent accounts with a clear aim to improve overall performance because if these problems are not caught early on, a high delinquency rate could be a sign of a bigger problem.

Final Word

Train your staff and give them all the resources they need to handle accurate claims processing to help them make the most of modern billing software and services. It is most essential if you want to be the best medical billing company in the United States of America.

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