Since the healthcare industry is always changing, it means that the billers and coders who work in this industry must also be changing at all times. All of these staff members must be up-to-date on the most current practices to follow when billing and coding is happening. This way, your medical facility holds onto as much money as it can. With new billing technology and tools being added to EHRs, many people feel that medical billing and coding is never going to be the same anymore. This kind of technology helps facilities avoid mistakes during billing and coding, and also ensures everything gets submitted on time. However, there are still practices that are not collecting as much revenue as they could, which is why we want to review ways that you can maximize revenue. Here are medical billing tips to use so that your facility can get the most out of your collections.
Get Coding Done Properly
To maximize collections, getting medical coding done correctly is one of the most important steps. You must code properly to comply with industry standards, and in addition to this, you reduce the number of rejections you receive. This way, you get as much reimbursement as you can for the services you’ve provided. Every claim has a fee that must be paid before you can resubmit it, so for each claim that isn’t filled out correctly, that’s extra money your facility loses. If you want the most collections possible, getting claims right the first time is best.
Submit Claims That Are Clean
Naturally, the more claims that get rejected, the more you will spend on claim resubmissions. For this reason, just be sure all the claims that get submitted are completely clean. Clean claims result in faster reimbursement, and you can optimize your collections in this manner. A lot of facilities have first pass acceptance rates at around eighty percent, but this is not where you want to be. Medical facilities should be at around a 97% acceptance rate if claims are being submitted as they should. If you’re not reaching this percentage, find out the causes for your claim rejections and see if you have the right technology that suits the needs your practice has.
Payer Contract Enforcement
Underpayment that is caused by payers can be an issue for medical practices that want to get the most from their collections. It results in a great deal of lost revenue if you don’t manage and enforce your payer contracts as you should. Since keeping track of all your contracts can be difficult, having the right technology can be a big help in this regard. The right kind of technology will be able to both track down underpayments, and help you dispute these underpayments with your payers so that you can receive the reimbursement you were hoping to get.
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