You may have noticed that your medical practice is not generating as much revenue as others. While they may be offering the same kinds of healthcare services, it makes you wonder if you’re doing something wrong in terms of your medical coding and/or billing. Don’t dismiss this outright; especially when your practice has plenty of patients and you know you should be profitable.
Understanding revenue loss can be difficult and requires examining a number of factors. Here, we will take a look at a number of reasons your medical practice may not be seeing revenue numbers that you would expect and what you can do differently about that.
Understanding Billing Rules
There are proper standards for billing rules within the medical industry that your medical practice should follow, however some rules allow for a variety of interpretations. It may be the case that a different practice that offers the same service is interpreting the rules differently. If this is where you’re missing out on revenue, you want to bring a partner in to help you understand these rules and avoid under or overbilling. Both situations could be problematic for your medical practice.
Incomplete or Incorrect Credentialing and Enrollment
Updating the credentials and enrollment of new providers on time is key to running a successful medical practice. It can have a big impact, and failure to do this will mean delayed payments, claim denials, out-of-network services, and even loss of revenue for your practice. It’s why it’s so important that you update credentials and enrollment at regular intervals while running your medical practice.
Minimizing Claim Denials
It’s a very common issue for medical practices to struggle with the number of claim denials they receive. However, that doesn’t mean you should give up on following up on them. There are plenty of reasons that claims can be denied, from coding errors, lack of information, duplicate claims, eligibility, and even late claim submission. That said, make sure you monitor why claims are denied, follow up on each, and begin to create a plan to prevent further claim denials in the future.
Find the Right Software for You
The market for medical billing software is saturated, with many options available for all types of medical practices. It’s key that you find the right one for you though; because software can help you optimize your billing and increase revenue. Good software may be able to notify you whenever data is missing from your billing, and can then help you update or change codes. Modern software will help you prevent revenue leaks. If your practice is failing to take advantage of what’s out there, this will put you at a disadvantage in the market.
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