Our

Blog Main Image Here

Latest News

Boost Your Payment Collections with These Six Effective Methods

Struggling with Payment Collections? Here are 6 Effective Methods to Improve Your Clinics Revenue

Due to the rise of high-deductible health plans, many people cannot pay for their rising medical costs. The rise in high-deductible plans has increased medical expenditures many individuals cannot afford. This issue is likely to be resolved sometime soon since patients are forced to pay increasing co-pays or pay out-of-pocket for office visits. This development indicates that medical practitioners must prioritize boosting their success rate in collecting these bills.

This blog offers six methods for increasing medical bill collections in your clinic. According to ACA International, 29 percent of adults have medical debt or are having difficulty paying their medical expenses. These figures indicate that something has to be done to improve patient collection.

In the hope of finding a solution, some physicians are undertaking the often-radical leap to alternative payment methods. But there are ways to get more money from patients without making big changes to your clinic. 

 

Gather patient insurance information and contact information prior to appointments:

Whenever a patient contacts your clinic to set up an appointment, front desk staff must gather updated, full data or provide patients with the alternative of mailing or emailing it instead. Fields for collecting or updating such details should be available on your service portal or online appointment tool. Employees can check insurance and follow up with patients throughout the treatment and collection processes if insurance and contact details are valid.

 

Increase the number of payment choices available to patients:

Whenever patients pay their balance, your office profits. So, if a patient wishes to pay respectably, there must be no limits. This includes accepting cash, check, debit or credit card payments through a digital payment portal. This last choice is crucial as Americans increasingly embrace online bill payment for ease. Patients do not need to travel or write anything by hand to make online payments.

 

Announce a reward for your employees:

To increase your collection rate, consider implementing an employee reward program. A rewards system should pay for itself by boosting the money generated by each collection worker. Assume that each collector at your clinic averages $2,000 in overdue bills per month. If you give employees a $100 voucher if they raise the goal to $2,500, you will earn an additional $400 per month from enthusiastic employees who meet the target. There is no harm done if some employees do not. The trick is to prepare the program properly. Evaluate your figures to determine when your practice can provide a compelling reward to staff while boosting total income.

 

Be persuasive, not rude:

In collections, there is a narrow line between telling your clients they need to pay their bills and bothering them. You should contact patients to inform them of their liabilities and try to work out a repayment schedule, but you must do it during "appropriate" times, between 8 a.m. and 9 p.m. Instruct any collection agents to be courteous in all dealings with patients. Patients are more willing to cooperate for settlement with something they like than someone they dislike.

 

Make Payment Processing Simple:

Transactions should be as easy as possible, meaning there should be as many ways to pay as possible. Collection percentages will be higher in practices that accept credit cards and online transactions than in those that do not. Online payments also benefit from drawing more patients to your platform, which will ultimately help you meet your webpage purposeful usage standards. Patients with significant invoices will likely be unable to pay them all simultaneously. Therefore, seek to establish payment options.

 

Closely monitor collection outcomes:

Checking and monitoring the outcomes of your endeavors is critical to increasing your collection rate. Because only some tactics are appropriate for some practices, you should analyze your collections at least once a month throughout a fiscal session to identify useful measures. It is also common practice to approach patients about past-due invoices once a month. However, if your team can handle it, you should attempt to do so once a week, as constant communication can often persuade many people to pay their invoices. An incentive system might also encourage your employees to do this often-difficult activity.

 

Billing Software Management:

If you dont use billing software, payments are more problematic than they should be. This software is available as a separate product but is frequently incorporated into larger practice management packages. These systems can perform various duties that can help you optimize your practices management, such as detecting patients who are still behind in their transactions, tracking past-due bills, and managing late fines. A viable approach will cost more, but it will also minimize your billing costs and boost your collection rate.

 

Collaboration with a Medical Billing Service:

Unpaid invoices from a clinic will ultimately be forwarded to a third-party bill collector, which will take a share of any monies collected. Because you willl be paying to recover these debts anyhow, consider hiring a medical billing firm to act on your account. This agreement enables you to raise your income while maintaining your concentration on your patients.

 

Receive Payments in Advance:

The optimum time to pay is on the day of the visit while the patients are present in your clinic. If you ask patients to pay when they arrive, you dont have to spend work time chasing them down tomorrow. You should notify the patients of their copay commitments. The precise words can make a significant difference. For instance, do not ask patients, "Do you want to pay today?" Instead, portray it as a given, as in "How will you be paying today?"

 

Conclusion:

Patient payment commitments now represent a significantly higher proportion of most organizations yearly profit than five years earlier. Patients have become significantly more cautious about their physician selections as they tend to pay much more out-of-pocket. Most patients carry out research for healthcare in the same manner that they do for major consumer expenditures. Exceptional healthcare extends beyond treatment. Patients also require great service and interaction throughout the procedure, including billing.

Blog Main Image Here

Latest News

Types of Medical Billing Systems: Overview and Benefits

What is Medical Billing System?

Medical billing is the process of submitting and following up on claims with health insurers to obtain reimbursement for services provided to patients. A medical practitioner (physician, dentist, chiropractor, etc.) generates a bill for services rendered and submits it to a third-party payer (insurance company) for reimbursement.

 

Medical billing may involve:

The U.S. has a multi-payer system for medical insurance, wherein insurers may be government or private organizations that provide their members malpractice insurance or health care coverage. Also, the insurance industry and medical profession have developed a set of rules known as the "standard of care," which guides how medical practitioners provide care to their patients.

Medical billing is a very important aspect of the medical office. A medical billing system can make this process easier. The medical billing system is designed to make the medical office more efficient. Medical billing systems can save time and money and make providing healthcare more manageable.

Medical billing software can be designed for all types of medical offices, whether private or physicians offices. This system allows for a more efficient billing process.

Medical billing software helps medical offices manage their staff better. With medical billing software, employees can access their schedules and log in to their information through the network. This helps with tracking hours and employee attendance. Employees will also have a lot more information, like reports that tell them where they need to go or what they need to do, as well as any new forms or procedures recently implemented.

Medical offices get paid in different ways. Some are paid by cash, check, and credit cards, while others are settled monthly. Settling monthly payments might require an extensive medical billing system that can handle all the processes effectively. The right medical billing company will help you save money, time, and effort on your insurance billing system.

 

In the Healthcare Industry, there are three main types of Medical Billing

There are three basic types of medical billing systems in healthcare.

 

 

CLOSED MEDICAL BILLING

A closed medical billing system, like an EMR, will concentrate on a singular goal. This means the system focuses on the EMR itself and the payment methods used in that EMR. EMRs do not quickly transfer to other designs because they are closed. However, if you are operating a single practice using a single payment method, consider using a closed billing system.

Embedded in this are a series of problems. First, transferring patients to other physicians is a facility that is outside the conventional system of paper charts. As such, this feature alienates much older practices that need more resources or vision to adapt. The second major problem with a closed-billing system is the issue of consent and authorization. When you send your patients information to another physician, you must ensure you have that patients permission and approval. Without support and consent, you cannot send the information and thus cannot switch medical files from one medical practice to another.

 

OPEN MEDICAL BILLING

The three main types of billing systems are open, closed, and isolated. Open billing allows patients to go to different healthcare services without transferring their information. If a patient visited a hospital, they could see another healthcare service without filling out forms again and having payments rechecked. The main difference between this and closed billing is that one can use their service elsewhere. On the other hand, closed billing means that you can only use your service at one location.

Medical billing software, such as Cure MD, Care Cloud, Kareo, Dr. Chrono, etc., must communicate and collaborate efficiently. In open systems, not all software can be used since it is restricted to keeping it closed and providing the only access to records of sick people. Similarly, HIPAA requires that practitioners and healthcare facilities protecting patient privacy be careful with open billing systems.

 

Isolated Medical Billing

When we talk about an isolated medical billing system, it is a system that is used to collect data and charge for medical services only. In the case of isolated billing systems, personal health records (PHR) are used. Personal health records allow people to store their health-related information in one place, including conditions, allergies, medication, lab results, lifestyle information such as smoking and drinking habits, exercise routines, and much more. Patient-generated data may be added to support care coordination between multiple providers and support disease management or wellness programs.

There is no use for isolation billing systems for personal health records, as they cannot legally replace official medical records. Patients personal health records can be filled out with official medical records using suitable software. It is essential to ensure that communications are open among all software for the transformations to be accurate. Regarding medical billing systems, every system has its fair share of benefits and drawbacks. There is no denying that records play an integral role in determining the types of medical billing systems that you want for your practice, but they are not the only factor. As soon as you have chosen a record-keeping system, you are ready. It is up to you to select new software or keep the one you have. It will help you determine how to outsource medical billing and coding by reviewing the types of medical billing systems available.

Blog Main Image Here

Latest News

Understanding Medical Billing Process: Guide & Common Errors

A Comprehensive Guide to the Medical Billing Process in Healthcare Organizations

 

Recognizing the Billing Process

A wide range of medical services are billed to third parties by healthcare providers, particularly local health departments (LHDs). The sharing of data is at the core of the provider-patient interaction. This comprises not just procedural or bureaucratic details but also counseling and resources supplied to the patient as part of the medical appointment by the physician or LHD.

As a result, several types of data are fed into the medical billing process at various times. The medical billing process starts when a patient enters an LHD by appointment or as a walk-in patient. Collecting insurance data from the patient is the initial encounter and an example of information sharing. This could be private insurance, government insurance like Medicare or Medicaid, or additional insurance. Even if the person has previously visited the LHD, obtaining insurance details should be repeated to record any changes. Validation and qualification by the insurance company are key pieces of information gathered.

Additionally, the LHD or provider will collect co-pays, deductibles, or self-pay sums. The data obtained at this stage is crucial for avoiding billing inaccuracies and mistakes. Insurance claim denials, potential income loss, and the investment of extra staff resources to hunt down payments, edit, and resubmit claims result from failing to capture and verify this data. Following the front office engagement, the person will frequently meet or communicate with a healthcare expert. This person could be a registered nurse, nurse practitioner, physicians assistant, or doctor.

Additionally, the LHD or provider will collect co-pays, deductibles, or self-pay sums. The data obtained at this stage is crucial for avoiding billing inaccuracies and mistakes. Insurance claim denials, potential income loss, and the investment of extra staff resources to hunt down payments, edit, and resubmit claims result from failing to capture and verify this data. Following the front office engagement, the person will frequently meet or communicate with a healthcare expert. This person could be a registered nurse, nurse practitioner, physicians assistant, or doctor.

 

Usual Medical Billing Errors:

Important medical billing errors can occur at many points during the patient-provider relationship. LHDs must be aware of possible major billing issues and how to successfully prevent them from preventing them from managing a cost-effective and efficient medical practice. This section discusses some of the most common medical billing issues and blunders.

 

Insurance Verification Failure:

Insurance concerns are the leading cause of insurance claim rejections. Failure to verify is frequently caused by dependence on a routine. Consider a patient who comes in regularly. In this situation, the staff thinks that the insurance provider or coverage plan has stayed the same and fails to confirm qualification appropriately on each occasion. Because insurance data might change at any time, confirmation is an important first stage in the billing cycle for every patient visit. To avoid the following insurance-related medical billing issues, LHDs must verify eligibility before providing services to patients:

 

  • On the date of service, coverage had been discontinued or was otherwise ineligible: A change in insurance status, which either cancels a plan or integrates a switch between private insurance and Medicaid, is one of the more common occurrences. This is especially true in volatile economic times, when people may face several losses or long-term unemployment. As a result, LHD front office employees must assess each patients qualification at each visit to confirm that the patient is insured on the treatment date and is qualified for more than one program or health plan. A related issue is whether or not an LHD is deemed a contributing provider under the health plan. If LHD personnel fail to check qualification or provider status, claims may be denied after the fact, placing the responsibility on the LHD to chase down self-pay, which patients may or may not be able to give.
  • Services not authorized: In other circumstances, a person may actively participate in a health care plan, but the plan may not authorize certain treatment care from the LHD that the person wants or needs. Even though this is a problem with public insurance, LHDs still worry about getting the cost of treatment back. If you make this medical billing mistake, the payer wont pay the claim because they didnt agree to the treatment. Once the service is given to the patient, the LHD is under pressure to pay back the costs. Obtaining permission before giving service eliminates this problem.

 

  • Services not covered by the plan: Front office workers who fail to check which services a health plan covers, similar to permission difficulties, can expose the LHD to insurance claim denial and corresponding investment risk. To deliver non-covered services, the LHD shall explain the treatment that is not covered, if covered options are available, the cost of the service, and terms of payment or plans to the patient.

 

  • Maximum benefits reached: In some situations, a person may have attained the full benefit in his or her plan for a specific period of time or event. If an LHD fails to identify these boundaries, the subsequent claim will be denied by insurance.

 

The Incomplete Claim:

Multiple electronic forms or physical documents must be created and submitted during billing. Many medical billing systems now permit insurance paperwork to be saved in a database or electronic format, thanks to the introduction of electronic health records (EHR). Medical professionals gather information at several points in the record-building process, including the previously described demographic and insurance data and the providers engagement. Healthcare providers rely on a "superbill" that tracks customer services to calculate the amount to be included on a specific claim. The superbill, also known as an encounter form, contains information about the services delivered and a statement of why the services were delivered.

 

Coding Errors:

An authentic portrayal of the services supplied to the client is required to file an insurance claim. The claim describes the services given by utilizing several diagnostic and procedural codes. Sometimes errors during coding amount to medical billing errors.

 

Lacking Specificity:

Third-party payers frequently decline claims for not being classified in the utmost detail or for being shortened to diagnostic codes. Qualified medical billing coders know that each diagnosis must be coded to the top level for that code, which is the codes maximum number of digits. If the LHD staff members in charge of filing insurance claims are unfamiliar with coding, the LHD stands a higher risk of claim denial.

Missing Filing Deadlines:

The timeframes for submitting can vary greatly based on the rules implemented by various third-party payers. Some insurers allow two years to file some medical claims, while others only allow thirty days. Due to this difference and the need for proper information, people often miss the deadline and cannot file a claim within the specified period.

 

Overcoming Medical Billing Mistakes:

The best way for a doctor or LHD to fix medical billing mistakes is to look for ways to reduce mistakes. Based on what we know about the industry, the following ideas are good ways for an LHD to fix important and common medical billing mistakes. The recommendations are not necessarily exclusive and may not apply to all LHDs. In many circumstances, elements unique to a single LHD may define how that LHD handles medical billing error solutions.

Invest in Staff Training:

The level of job training in medical billing difficulties significantly affects the number and intensity of medical billing mistakes, regardless of whether an LHD has a dedicated billing team or personnel with numerous job duties. Given the volatile regulatory and economic environments, LHDs must invest in well-trained personnel to develop (or sustain) income streams related to third-party billing payers. This investment can take numerous forms, including direct medical billing and coding regulations.

 

Improved Procedures and Protocols:

Many medical billing problems occur as a result of billing procedure malfunctions. More stringent regulations or recorded procedures can reduce the likelihood of claim denials in these circumstances.

 

Billing can be outsourced in part or in full:

In many circumstances, by outsourcing the task to a certified third-party contractor, LHDs can minimize or remove medical billing problems. In these circumstances, the LHD will free up staff resources to focus on other administrative or medical matters. These medical billing organizations get service data from clinicians to fulfill the cash flow back-end operations.

 

Audit Claims:

Finally, LHDs should incorporate an internal audit procedure for submitted claims. Auditing denied claims to determine what mistakes or omissions were committed to filing the claim is part of this process. Suppose the LHD discovers a relatively large number of requests being denied owing to insurance coverage difficulties. In that case, procedures can be implemented to address front-office workers who may need to make more mistakes during the intake and insurance confirmation stages. However, if several claims are being denied owing to treatment and diagnosis miscoding, an LHD can focus on improving communication between care providers and billing personnel.

 

Conclusion:

A consistent and reliable funding source is required to run a profitable, efficient LHD. This includes increased invoicing engagement with third-party public and private payers for LHDs. On the other hand, an increase in healthcare billing claims can result in an increase in medical billing errors and mistakes. This white paper discussed seven of the most common medical billing errors and provided ideas on how physicians and LHDs might collaborate to reduce their failure rates.

Don’t Want to Miss Any Opportunity?