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How to Create a Better Medical Claims Billing Process

How to Create a Better Medical Claims Billing Process
There are ways for you to make sure your medical claims billing process is at its best, raising your first-pass approval and submission rate.

Medical coding and billing processes are complicated. Billing can take anywhere from a few days to several months to be finalized if the patient has a case that is complex enough or they have a significant enough medical history behind them. There are ways for you to make sure your medical claims billing process is at its best, raising your first-pass approval and submission rate.

Maintain & Update Your Patients’ Files

Confirm that the demographics and insurance information are correct with every patient visit. Insurance carriers and coverage limitations could be changed if your patient either changes jobs or they reach an age that lets them in the Medicare program. Efficient claims processing not only involves confirming that you properly record the coinsurance percentage and policy number, but it also involves verifying the billing address of the insurance company and making sure that the subscriber information and policy number match the records of the third-party payer.

Train for Success

All insurance companies are going to have their own rules. That’s why you should have training programs in place with parts that let your billing departments access patient files and filing requirements efficiently to make sure that all carriers have whatever information they need to expedite claims processing post-submission.

Track Denials

Part of your medical claims billing process should be to monitor your denials. With each rejected claim, you gain insight into what could be wrong with your process. If your denial rate seems abnormally high, it could mean that your staff team should be given additional training. There is also the possibility that your scrubbing process isn’t sufficient enough. If you track your denials, you will be able to figure out what steps your practice should take to become more efficient.

Enhance Quality Control

It is vital that you eliminate as many claim errors as you can. However, just because your claim gets approved, that does not mean your billing and collections process is complete. Medical providers can keep surveillance on cash flow more easily if you use widely accepted accounting practices to post and record your payments.

One way you can ensure that you have accurate account balances is to create a deposit log designed for receipts that you can forward to your billing department. Make sure this log has all the information you need to guarantee proper posting, and it should allow reviewers to confirm that the right payment gets posted to each account without any hassle.

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This entry was posted on Wednesday, November 4th, 2020 at 10:29 pm. Both comments and pings are currently closed.