Medical billers should be highly attentive to details and follow best medical billing practices to generate good revenues for the healthcare providers. The aim of the medical billers should be to submit clear medical claims that get appropriate and timely reimbursement from the insurance providers that help in improving the collections for the healthcare provider. Medical billing can be a lucrative and satisfying career and there are many companies that provide medical billing jobs in Hyderabad.
Medical billing along with the collection process is one of the most important factors in determining the success and profitability of a medical practice. Here we will discuss few tips to improve medical billing practice.
Initial verification: Medical billers should always verify the insurance eligibility for the patient before providing medical services. Many times inaccurate or incomplete insurance information are the major reasons for the claim denials. Vital information regarding patient’s identity and insurance card should be collected from the patient at the time of check-in. It is advisable to keep a copy of the patient’s identity proof and insurance card in the records to be able to quote them in claims when required.
Benefit verification: Ensure to verify the benefits applicable to the patient before giving medical service. Contact the insurance provider if necessary and cross-check the details. Double check the details regarding.
- the effective dates and validity period for the insurance
- prior authorization for any procedures
Coding correct: It should be ensured that all the charges pertaining to the services provided have been coded appropriately and billing is done for all the services. It helps medical billers to understand the ICD 10 codes and identify any errors committed by medical coders. In case of any mistakes, they can be communicated to the coders to help them rectify those errors. This is a must follow procedure to ensure that collections are not falling short for the services rendered as wrong coding leads to denial or underpayment of claims in many instances.
Appropriate submission: It should be made sure that medical claims are submitted on appropriate forms in accordance with the specific medical policies for insurance, government regulations and guidelines. Get a hold on various insurance companies’ requirements for every kind of claims and provide all the required details. Ensuring that the claims are submitted correctly at the first time itself makes the claims recovery process easier.
Timely submission: The insurance claims should be submitted as soon as possible without any delay. It is a good procedure to set a deadline of 72 hours to submit a claim from the time of patient’s arrival. Have a review of the documentation of the treatment or service provided as early as possible to mitigate any chances of incomplete information. In case of any omissions or ambiguities, clarification should be sought from the physician immediately.
Payer Contracts: Familiarity with payer contracts gets your claim processed more quickly with lot more accuracy.
Follow up: Set some standard procedures for follow-up and appeals for claims rejected or claims not paid as expected. Ensure that these procedures are followed and include the patient in the follow-ups if necessary. Including patient in the follow up brings positive results many times.
Few procedures systematically followed by medical billers can drastically improve collections for a healthcare provider. If you are interested in joining the brigade of medical billers, then, join Avontix, the best medical billing company in Hyderabad.