Cash flow is the lifeblood of any business in the economy. Cash flow and realising the proper reimbursement from insurance companies become more important in the case of hospitals and healthcare facilities. Completing the billing promptly and efficiently and submitting the correct claims will ensure prompt payment from insurance companies.
How to Ensure Medical Billing Accuracy?
Finding out the extent of the insurance coverage
Insurance companies have varying degrees of coverage for different illnesses and treatments. Some medical treatments are not covered at all. Accurate billing depends on ascertaining the extent of insurance coverage and the extent to which the patient pays. The lowest insurance coverage determinants should be identified. This will keep our billing processes accurate and ensure that proper medical bills are submitted, which will be promptly reimbursed. All details about the reimbursement procedures should be identified, which should determine the billing process.
Clarify the collection process upfront
After adequately registering the patient details at the time of registration, we also need to clarify the collection process. Whether they are covered by insurance or self-pay patients, the initial paperwork should be included. Explain your billing and payment system to the patients so there is no ambiguity or dispute about the payments. Keep a copy of the patient’s insurance card, credit card and other relevant information in the patient’s files.
Automate the billing processes
Manual billing and invoicing processes increase the scope of errors. This enables the hospital to concentrate on more patient-centric, personalised services instead of being occupied by administrative tasks like billing. Billing tasks are repetitive and routine and can be outsourced easily. This enables more patient-focused service medical treatment delivery. The billing cycle from invoicing, submission of insurance claims, and following up on claims can be outsourced to an outside agency, ensuring more accurate billing to improve our bottom line.
Verify submission reports
Submission reports verify that claims have been appropriately filed with the insurance companies. The return reports also confirm the reasons for the rejection of the claims. Any claims left undocumented or containing errors can also be rectified and resubmitted. These electronic reports ensure that we are kept in the proper loop for receiving notifications from insurance companies. This avoids unnecessary delay in refiling and resubmitting the claims. These feedback reports will enable you to keep your medical invoicing accurate and ensure prompt insurance claim processing.
Verify any denials from the insurance companies in claim processing
Insurance company reports are always not error-free. After all, human errors in data entry or processing can occur anywhere. If the insurance company refuses a claim, investigate it thoroughly and do not take anything the insurance company says in its reports at face value. You will also get the opportunity to verify the accuracy of your billing. Denials must also be filed and tracked in our computer systems. A system of checks and balances will ensure better claim processing rates. If the internal staff are not adequately trained or proper supporting documentation is not attached, this may increase the denial rate.
Companies should outsource medical billing services to help reduce billing errors and facilitate the fast processing of medical insurance claims. As there are professional accountants who prepare the medical bills for our hospital or healthcare institution, this will reduce the incidence of human errors and prevent denials or rejection of the medical claims submitted.
Approaching a third-party service provider
Hospitals and healthcare facilities need to use an outsourced medical invoice processing agency, and this service can be easily extended to pharmacies. A revenue cycle management service company becomes an objective third party facilitating faster collections. Pharmacy billing services for medicine prescriptions use experts for bill collections, ensuring that all invoices, including complex invoices, are also efficiently and seamlessly collected. This will help your cash flow and revenue cycle and keep your business profits up.
Enhancing quality control in billing, insurance claims and collections
Eliminating billing, claim and errors, and omissions are critical for your hospital’s financial health. Billing and claims alone do not complete the entire cycle. Afterwards, they must be entered and captured in our accounting systems. Updating the accounting books per the accounting regulations helps our hospitals track the impact on revenue and profit flows. Complete details for every patient should be entered, and this can be best done when it is outsourced to an all-in-one billing, claim processing and accounting firm, which relieves the pressure of the administrative tasks.
Following up on delinquent claims
Any claims the insurance company rejects should ultimately be collected from the patients themselves. A third-party outsourced services company that operates at arms-length with the patients can effectively follow up and collect delinquent claims. This will help your hospital and staff avoid dealing with unhappy patients.
Key Takeaways
The medical billing industry is constantly changing and evolving. Staying educated makes us more aware of the options available. This will also enable us to avoid denied claims and financial losses. Staying aware of the options lets us keep abreast of the best ways to ensure an accurate and reliable billing system.