How to Run a Smooth Medical Billing Process: Avoid Common Pitfalls?
It is not uncommon for medical practices to experience some difficulties with the medical billing process. It can be complicated, time-consuming, and stressful. But it doesn’t have to be this way! There are many steps that you can take to avoid common pitfalls of the billing process, which will ultimately save time and stress for you and your staff. We’ll discuss three ways in particular which you should focus on if you want a smooth running billing process (and more money!).
Table of Contents
Patient Check-in
It is best to have a secretary or receptionist available at all times when patients are arriving for check-in. This way, the patient can be checked in quickly and accurately while also having someone on hand who knows how to file claims correctly (specifically where you need them sent). You don’t want your staff members tracking down information about a patient, filing a claim, and then finding out that they filed it in the wrong place. It can be very frustrating for your staff members to have done all of this work only to discover there is no money coming back into the practice because you sent everything somewhere else!
Check-In Process: If possible, use electronic check-in instead of paper. This will make the process much smoother and faster, as your staff can simply type in the patient’s name and insurance information. If you are using electronic check-in, be sure to have a backup plan (like someone who can input information manually) in case of technical difficulties.
In addition, it is important to verify that all of the information is correct. For example, if the patient only has one insurance card for you to verify, but they have several cards under their name (and there are multiple listed on your check-in sheet), then it will be very difficult and time-consuming to track down which policy number belongs to this particular individual. If a mistake like this happens often, then your staff members may stop verifying that information altogether and just input whatever they can find.
This will only cause more problems in the future, as you have now opened up a claim to being rejected because it is missing important information! For this reason alone, it is much better for everyone involved if you make sure all of the patient’s insurance information is correct before filing the claim.
Patient Check-out: It’s important to check out patients quickly and accurately as well, especially if you are having them fill out paperwork. Make sure any forms you have your patients fill out to contain all of their insurance information so that it can be double-checked when they leave (and then filed correctly).
Insurance Eligibility and Verification
Another common pitfall of the medical billing process is incorrectly verifying patient insurance eligibility or not doing so at all. If a claim is submitted and it turns out that the patient does not have coverage for this particular service, then you will end up having to pay for their visit yourself – which means less money in your pocket! This could be very costly for your practice, as you may not be able to absorb the cost of all these visits.
One way to avoid this is by verifying insurance eligibility BEFORE services are provided. You can do this in a few ways:
– Have someone on staff who is specifically responsible for verifying insurance information (and make sure they are up-to-date on all of the changes that occur with insurance companies).
– Use a software program that verifies eligibility (there are many different programs available, so be sure to do your research and find one that is best suited for your practice).
– Contract out eligibility verification to a company that specializes in this service.
This will help ensure that you are not wasting valuable time and resources on patients who do not have coverage. Better yet, it will save you money!
If the patient is insured but there are certain lines of insurance that they do not fall under (such as Medicare), then make sure to write this information down somewhere so that when your staff members file claims, they can quickly see if the patient’s insurance is accepted. If it isn’t, then they can have a conversation with them about other options that may suit their needs better.
Even if you do not submit claims to Medicare yourself as a provider, having this information on hand will be helpful in case your patients want to file for reimbursement themselves (and need some help understanding what they need to do).
These are just a few of the many ways you can avoid common billing pitfalls. By being diligent and taking the time to plan ahead, your medical practice can run smoothly and without any major hiccups!
Medical billing can be difficult and complex, but it is entirely feasible for things at your medical office to go as planned. When this happens, a claim is generated and only has to go through the process once instead of having one or more phases repeated. This considerably shortens the amount of time it takes for a claim to be paid. That is why it is important to choose the best medical billing service for your practice.
Ifying that information altogether and just input whatever they can find. This will only cause more problems in the future, as you have now opened up a claim to being rejected because it is missing important information! For this reason alone, it is much better for everyone involved if you make sure to verify insurance information BEFORE services are provided.
Charge Entry
Another common billing mistake that is made is incorrect charge entry. This can be caused by a number of things, such as incorrectly keying in the information or using the wrong codes. If this happens, it will throw off not only your billing process but also your accounting and even patient statements! This can be very confusing for everyone involved and may end up costing your medical practice more money in the long run.
To avoid this, be sure to have someone on staff who is specifically responsible for charge entry and is well-trained in doing so. They should also be kept up-to-date on all of the changes that occur with insurance companies and coding systems. You can also use software programs to help with charge entry (again, be sure to do your research and find one that is best suited for your practice).
If you are contracting out charge entry to a company, make sure that they are reputable and have experience in this field. The last thing you want is for someone to incorrectly key in information and cause even more havoc than before!
Claims Submission
Another common billing mistake that is made happens after insurance claims are submitted to an insurer. If the information isn’t filled out properly, then you could be in for quite a headache! Many providers choose to just submit any claim they can without checking up on it much afterward – which leads them right back into another pitfall: lost or delayed payments.
Payment Posting
One of the last steps in the billing process is payment posting. This is where all of the payments that have been received are put into their correct accounts and tallied up. Unfortunately, this step can also be prone to mistakes if not done correctly. For example, if you post a payment to the wrong account, it will throw off your entire financial statement!
To avoid this, it is important to have a system in place for payment posting that is both efficient and accurate. This means having designated staff members who are responsible for doing so and using software that helps to automate the process as much as possible. In addition, you should always verify payments against invoices before posting them – just to be safe!
As you can see, there are plenty of ways that billing mistakes can slip by even the best-trained staff members. To ensure your medical practice runs smoothly and efficiently, always take care to check over everything at least twice before moving forward with it! Otherwise, you could end up wasting time and money on both ends – which is the last thing anyone wants.
If you’re a small or medium-sized medical practice, following these five steps should ensure that the experience of billing is smooth. If at any point in this process your business isn’t so prepared and confident – then take some time to reflect on how much has improved since starting out!