Most Common Problems in Medical Billing And How To Overcome Them

From time to time physicians have come across issues in the medical billing process, that seemed to be painful and medical billing processes act as a backbone and they are integral to maintain an efficient revenue cycle for your practices. According to a report issued by the Centre for American Progress, the cost spent on medical billing and insurance by the healthcare providers is approximately about $282 billion. Due to the high cost of medical billing, healthcare providers need to avoid any errors that can further add to the cost of billing management.

Both the healthcare providers along with the third-party medical billing service providers should partner up to design strategies and proper plans to overcome any challenge that can negatively affect the revenue. It is important to address these errors as medical billing involves health and money and both are very important factors for the growth of a medical provider. However, sometimes it is impossible to avoid such mistakes which can be due to either human or machine error. Below we share with you some important medical billing pitfalls and how can you overcome them.

Not conveying the actual cost of a service to the patients

It is important to understand that your patient might not always be well-educated about the medical expenses. It can be a challenge for the healthcare provider to collect payments from patients since more and more patients are paying for their own medical expenses that going for healthcare insurances. The responsibility falls on the shoulders of the healthcare providers to educate the patient and talk to them about the medical costs that will incur. However, with good communication and an easy and diverse payment method this challenge can be tackled. Another thing the healthcare provider can do is to use a more customer-centric approach and provide transparency in the pricing and healthcare services to help patients avoid confusion. Besides that, providing a wider range of payment methods (Credit and Debit cards, cheque) will provide more transparency and ease of payment to the patients.

Denied Claims

In medical billing, submitting claims on time is extremely important. If the claim is not submitted on time it shows the provider’s inefficiency to manage and file claims. There can be many reasons the claim is not submitted on time, for example, providing incomplete, illegal or incorrect information can make it hard to get payment acceptance. It is important to know the claims that exceed the submission deadline and are mostly rejected and not paid. A claim that is sloppy and not very specific has a higher chance of being rejected. Hence, it is essential to make sure you rectify any such errors before submitting the claim.

Filing a claim using manual and outdated processes

Filing a claim is a complex and daunting process. There are many factors involved, such as, efficient communication, highly skilled staff, modern data analysis, and management technologies. There are more chances of inaccuracies if you use outdated manual processes for claims management. You have to face challenges in providing valuable experience to your consumers. Besides, it can lead to a decrease in revenue generation leaving you unable to achieve your financial goals. It is important to use an automated process for filing your claims. One way to ensure fewer errors and increase revenue is to outsource your medical billing to well-known outsourcing billing providers especially if you are a beginner and cannot afford high-cost medical billing resources for your practices.

Neglecting any changes in insurance coverage

Every time the services are provided it is important to check for verification as insurance requirements change from time to time. It’s possible that the patient’s insurance coverage has been terminated or there have been some modifications. Hence, it is vital to check the eligibility requirements at the time of providing the service. Carelessness in the verification of insurance benefits can lead to termination of the claim which can adversely affect the revenue. One way to avoid such risks is to hire a specialist that thoroughly verifies each element of the insurance. This can lead to fewer claims denial and timely submission of claims.

Billing is an integral part of any healthcare practices hence it is essential to deal with any error on time. Make sure to double-check the bills to avoid any unspecific, illegal or missing information that can decrease the acceptance rate of the claim. One suggestion is to outsource your medical billing. According to Globe Newswire, the size of the outsourcing market in the U.S. is supposed to grow $7.8 billion by the year 2026. There is a growing rate of physicians who consider outsourcing a good option for their practice. The third-party billing service provider is obliged, contractually, to provide you with services that they must help enhance your collections and maintaining consistency.