The medical billing and coding process is a complex. When a patient presents with a significant medical history or complicated case billing can be time-consuming taking days, or months, to finalize. On top of that recent amendments to the U.S. healthcare system have added a variety of new challenges for both providers and patients. Various aspects of healthcare reform, like the introduction of more time-consuming, value-based compensation models, can incur revenue losses for providers across the United States, and the frequent alterations of billing rules and regulations don’t help either.
With estimates indicating that four out of five claims have a probability of getting rejected, which means that almost 80% of medical bills contain errors. Whether it is double billing or lack of documentation backing up the claim or a simple typing mistake in an account number, whatever the reason the output is the same – Denial of reimbursement. According to some estimates, U.S. medical providers left approximately $125 billion in uncollected revenue. That said there are methods to enhance the billing and coding process, which will result in higher first-pass approval percentages and faster submission times. By taking a more proactive approach to their billing procedures the compliance issues and financial issues can be avoided by practitioners.
Proper Management of Claims
Insurance companies are very particular about correct coding practices and medical billing. So if your bills contain error the probability of claim rejection increases. It can often take months before providers receive payment for their services due to the time taken by the cycle of submission, Denial, Correction, and re-submission of claims.
It is important to have claims accurate and complete the first time to avoid the wasted time and effort that goes into correcting and resubmitting claims. This involves entering the information accurately and rechecking claims for any possible error before submission.
Hence always double-check all the claims before submitting to minimize billing problems. Communication also needs to be frequent to verify if any information is incorrect, incomplete, or unclear. Following up with the representative of the insurance company and staying updated about any errors they may have encountered is also important.
Work Your Denials
Denials are the area that billers often procrastinate about the most and, like the least. It is important to understand the difference between a rejected claim and a denied claim to discuss this topic further.
When the insurance company has processed a claim and has classified it as unpayable due to some violation of the payer-patient contract or a critical error caught while processing it is called a denied claim.
Whereas a rejected claim is one that is yet to be processed due to the discovery of one or more errors. It is something that is preventing the insurance company from paying the bill as it’s written. The payer will resubmit the claim to the biller with an explanation of the problem in both of these cases. Corrections can be made to a rejected claim and resubmitted, but a denied claim has to be appealed before re-submission, which is a much more time-consuming and costly process. Be sure to handle the instances of rejections and denials occurrence of rejections and denials. Representatives of the insurance company can help clarify the problems with the claim and provide information on any current claims as they are processed. Staying in touch with them is beneficial.
All of this can help minimize re-submission and appeal times and expedite the claim editing process.
Hire the Medical Billing Professionals Whenever Possible
Medical practices have to constantly worry about their patients, proper staff management, and current trends in medicine. They also have to keep up to date knowledge about insurance companies, billing regulations, and coding standards.
Details can easily be missed with so much to keep up with, resulting in denials, rejections, and underpayments that cost medical practices money and time. As a result of multiplying rules and regulations and to cut labor costs, many practices are outsourcing their medical billing and coding to third party specialists. One of the best investments that you can make for your practice is by Hiring a medical billing company.
Our clients will vouch to you that we’re one of the best medical billing and coding companies in the industry. We work hard to enhance all aspects of a medical practice’s financial health. Your medical billing becomes quick, precise, and organized when you hire a pro.
Are You Ready to Get Billing?
Want to have an error-free billing and coding expert at your work? You are at the right place, what you need now is a partner who can finish out the rest of the work and make the technology and implementation just as simple. That’s what the best medical billing company like Medisys Data Solutions Inc can do. If you’re ready to get started, schedule a meeting with our medical billing manager from filling out enquiry form from our website!