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. Insufficient medical billing processes, from a business perspective, can contribute to a loss in profits, and increase the risk of non-compliant or inefficient workflows. In this article, we will highlight some common medical billing mistakes and different types of services available to optimize care while ensuring physicians are paid for services rendered.
Errors in billing occur in the vast majority of medical bills. Insurance providers scrutinize each medical bill for mistakes, which allows them to reject bills. Healthcare professionals must then either correct and resubmit the bill, which can cause long delays before receiving payment, or forego the payment entirely. The other major error that healthcare providers make is falling behind on compliance with billing regulations. In order to remain compliant, providers must undergo ongoing education and software updates. In addition to medical billing regulations, broad and general health care regulations are changing, too. As Americans gain health insurance as a result of the Affordable Care Act, providers must devote attention to billing practices to ensure that they remain financially secure.
Part of the reason medical practitioners are feeling the strain of lost income is that many patients don’t have the resources to pay for their medical care. Everything from unemployment or underemployment rates, to high insurance costs result in many patient’s inability to pay. In order to curb delays in receiving payment, healthcare providers can issue an estimate of treatment costs before treating a patient. By using software to discern a patient’s eligibility and provide cost estimates, providers should recover more money. In addition, many patients lack the information or understanding of medical billing and insurance to navigate the costs, which can increase the stress involved in the process. Therefore, providers should create a system to address areas of patient concern, which can include payment plans and financial counseling.
Another issue is the lack of electronic means for patients to pay their bills. To curb slow payments, more providers could send bills electronically, offer automated payment plans, or retain secure payment information. For patients who cannot pay their bills, using cost estimates, payment plans, and electronic services can help them plan for the costs they’ll incur. To reliably collect payment from these patients, offering several payment plans that are feasible for their financial situation can help.
When it comes to managing medical billing, keeping it in-house or outsourcing it carries benefits and challenges.
If providers are willing to pay the up-front cost of outsourcing, it may save them money in the long-run. By outsourcing, healthcare employees will be spared from handling denials. Third-party billing companies will also only charge a percentage of the money they bring to healthcare providers, which still leaves healthcare professionals with more money than they would have by being unpaid or underpaid for their services.
Another benefit of hiring a third party is that maintaining one’s own staff for billing is costly and time-consuming. From hiring and training staff members, to keeping them on the payroll, providers would escape that process by hiring outside help. And, with a separate company handling the billing, medical practitioners have to spend less time on administrative concerns, and can spend more time with patients.
Finally, third-party billing services may have more advanced capabilities and infrastructure to handle the billing. Outside billing companies can bring helpful software, such as Electronic Medical Records (EMR), or even services such as coding and data recording. The holistic approach to medical billing that a third-party may take can save healthcare practitioners time and money. And, certified billing companies are required to stay compliant with healthcare laws, which minimizes risk to healthcare providers.
For some, particularly smaller practices, in-house billing may be a viable alternative to outsourcing. When billing staff works in one internal office, it’s easy to get a hold of people to
resolve billing issues quickly. If the billing staff has a question about physician notes or patient data, they can ask the healthcare professionals directly and clarify the confusion. When a third-party billing company is involved, it may be more difficult to reach the company to respond to inquiries or issues in a timely manner. In-house billing can also reduce costs by adjusting staff workload and standards when necessary. While one can implement practices to increase staff productivity with an in-house billing staff, the same cannot be said for a third-party billing company, whose employees are not managed by their clients.
Maintaining an updated and proactive medical billing practice will help the healthcare industry operate at top potential and eliminate costly errors that inhibit their ability to provide the best patient care. As a partner in your healthcare practice, eReceivables will use our patented automated appeals software to pursue outstanding claims and maximize your payment collection. Our eAdvance propriety software can even help you solve cash flow problems while you await payments. We welcome the opportunity to assist you.