While healthcare reform has received a lot of attention in American policy in recent years, the healthcare industry continues to face challenges. Healthcare providers give top priority to patient care, but they must also collect payment for their services.
Medical billing is an integral part of the modern healthcare industry. Unfortunately, loopholes in paperwork and small mistakes throughout the process can impact a practice’s revenue. While, like coding, the billing process may seem multi-faceted and complicated, it’s actually comprised of just eight simple steps.
Revenue cycle management is a multi-faceted, complex concept, but also the bloodline of a medical practice. In today’s healthcare industry, patient billing and collections in particular has attained just as much focus as patient care.
In today’s fast-paced healthcare landscape, changes in regulatory demands, increasing pressures from payers, and on-going market consolidation have all contributed to a myriad of revenue cycle challenges and considerations.
Healthcare providers who outsource their medical billing process put significant trust into third-party billers, as they must monitor and manage the lifeblood of business: revenue.
Bundled claims, combining all services related to a treatment or condition into a single payment, are becoming increasingly common. These payments can include the services of multiple providers at once, which means that many providers could be taking on financial risk from a single payment, especially if a patient is unable to pay.
[Infographic] Is Your Claims Processing Pro-active or Reactive: Why Prevention is the Lifeblood of 2018 Denials Management
Increasing financial pressures have forced US healthcare leaders to examine their internal performance, identify improvement areas, and strategize how to increase profitability. While many healthcare organization’s once perceived denials as a necessary evil, recent data has revealed just how detrimental denied claims can be to provider revenue streams.
Ideally, when a healthcare provider dispenses medical care, patients pay their bills on time, and insurance companies reimburse the provider promptly so that the provider has a constant, reliable revenue stream. It is not uncommon, however, for payments from either patients or insurance carriers to become overdue for various reasons.
Medical billing and collections seem like relatively straightforward processes and components of a routine process that all health providers should be able to go through without much effort or variation. To do these things well, however, takes planning and constant vigilance, because billing and collections only run smoothly if providers continually make sure that they do.