Best Practices to Maximize Healthcare Providers’ Revenues

Medical billing and collections are the significant processes of a healthcare facility that should be performed by qualified professionals although it is a routine task. Medical billing is a science that needs appropriately integrating medical billing best practices into your revenue cycle management (RCM) process. To integrate the best practices and smoothly transit your healthcare facility towards increased revenues and improved bottom line, you may need to hire the top RCM services providers. Below listed are some of the best practices that will enhance your facility’s billing efficiency.

  • Start right – You should start the procedure right by capturing the accurate demographic and insurance information of a patient. This is the first step towards an efficient billing procedure. The front office staff dealing with appointment scheduling and collecting patient data should ensure they are taking accurate information and verifying it before giving an appointment for a doctor visit. This helps in avoiding errors related to patient information at a later stage and collecting co-payments without hassles.
  • Accurate and timely charges – Revenue cycle management professionals should ensure that they are making accurate and timely charges that help in collections without delays. A piece of important advice from RCM services experts is that at this stage, you should keep your fee schedule updated as per the latest changes applicable to government programs or insurance companies’ policies and procedures. Here, it is also significant that the medical billers closely coordinate with the medical coders and prepare the medical bills with the highest levels of accuracy. Another key aspect that you should not ignore while preparing bills is that your bills should be patient-friendly so that they don’t get confused with the complexity of the billing process and pay their part without delays.
  • Accurate claims – The key to timely reimbursements and collections is the timely filing of claims. RCM services providers or the in-house medical billers should ensure that they submit all claims to the medical insurance companies within stipulated timeframes and follow up regularly with the insurance companies. Having a streamlined process in place for the follow-up of claims ensures that the claims are processed in a timely manner by the insurance companies and you don’t pile up your accounts receivables beyond the set timeframe.
  • Communicating proactively – With the increase in out-of-pocket payments for patients in recent times, patients may find it challenging and confusing to understand and pay their bills. To make it easier for the patients, it is required that your billing staff communicate proactively with patients and make them understand the charges and the payment options available. This kind of communication from the staff will facilitate timely collections and avoid collection battles at a later stage.
  • Managing denials – Your revenue cycle management process is incomplete without a denial management process in place. Per the research, it is understood that more than half of the denied claims are never followed up on by healthcare facilities. If you are one of those, you need to revamp your denial management process and ensure that you have a backup plan ready to deal with denied claims. If you are not equipped with the personnel to tackle denial management, it is advised to hire RCM services providers because your gains in the form of reimbursements received will outweigh the costs of outsourcing.

Make the right decision to train your employees and ensure that they follow the best practices. Else, outsourcing is a great option where the RCM experts identify and provide remedies to your billing flaws, thereby increasing your revenue cycle efficiencies.

Best Practices to Maximize Healthcare Providers’ Revenues