Collection optimization is one of the numerous components of effective revenue cycle management. However, practices run the risk of losing out on money that is owed to them as well as significant revenue if they ignore this vital step.

However, it’s simpler than you might think to increase the cash flow of a medical practice. A number of variables, such as insurance verification and refusal management, affect healthcare income. If your billing department is having trouble keeping up, an adjustment may be needed. The first step in boosting revenue is to evaluate the internal processes of your billing department and spot any potential improvement areas. 

Here are the key tips below that can help a medical practice’s cash flow.

• Collect the patient’s insurance information and contact details before appointments.

When a patient calls your clinic to make an appointment, front desk staff should acquire current, complete information or provide them the option to mail or email it in its place. Your patient portal or online appointment tool should have fields for gathering or updating this data. If the right insurance and contact information are given, the staff will be able to verify coverage and keep in touch with the patient throughout the treatment and patient collection processes.

• Verify any unpaid amounts and confirm insurance eligibility.

Verify coverage with payers before or at the time of the service, and be sure you understand their rules. These actions will assist in identifying any potential changes in patient collections, the total amount of estimated treatment costs that will be reimbursed, and patient financial obligations.

• Set up a payment procedure that demands patient accountability at check-in.

The best strategy to collect patient debts is to have patients pay copays and patient responsibility upon check-in. To ensure that patients are aware of this requirement, the medical office should establish a payment policy. After that, have patients sign the patient responsibility form that is part of your check-in process. The purpose of this policy is to provide patients and your staff with clear instructions regarding collection. Deliver automated appointment reminders with payment details for the time of treatment using your patient messaging system.

• Accept a wide range of payment methods.

By allowing guests to pay with cash, credit/debit cards, checks, or other options, you increase the likelihood that you will be able to recover any outstanding sums at check-in. Patient payments can also be made easier if your patient portal has a practical and simple-to-use online payment mechanism.

• Provide payment plans and keep track of them.

Create payment plans for higher debt and educate staff on how to properly explain and manage these options. Giving patients a more flexible payment option will boost revenue for your practice and give them confidence that they can afford the necessary services.

• Include follow-up in your collection process.

Maximizing collections requires perseverance. Make a proactive plan for reaching out to patients who don’t pay their bills on time, and write a script for employees to follow. Your team ought to be equipped to ask for full payment, go over available payment methods, and, if necessary, propose a payment schedule.

How might a medical billing and collections service help?

Due to value-based treatment efforts, changing payer fee schedules, employee turnover, governmental regulations, a lack of resources and training, high-deductible health plans, and value-based treatment initiatives, your practice may be making less money than it actually is.

Maintaining financial stability in a regulated framework with many moving parts is difficult. You must know how to handle claim denials, improve denial management, deal with underpayments, and locate outstanding bills if you want to be paid for your services.

Health centers must follow the previously indicated patient collection guidelines in addition to maintaining their payer fee schedules, submitting secondary insurance claims, and making sure that appropriate coding is used to avoid undercharging.

To increase profitability, many companies work with revenue cycle management professionals. A medical billing agency can assist you in a number of ways to ensure that you get paid in full:

Accurate payment posting

In the medical billing process, posting payments is a crucial stage because mistakes in posted payments can reduce the accuracy of Accounts Receivable (A/R) reports and develop mistrust in patients who receive inaccurate statements. If you rely on a medical billing partner to post payments, you may relax knowing that any possible problems will be identified and fixed.

Tracking & Lowering days in A/R

Days in A/R refers to the period of time before collection that an invoice is unpaid. It’s critical to monitor this measure because failing to collect payments will diminish your margins and increase the likelihood that you will write off patient accounts receivable.

By figuring out the typical daily rates for the period of time you want to compute, you can calculate your days in A/R. Add the posted charges for the selected time period, deduct credits earned, then divide the result by the total number of days in the period to get your average daily charges. Afterward, divide the total amount of your receivables by the typical daily costs. The goal for practices should be 30 to 40 days in A/R. Having a partnership with a medical billing firm might assist you in tracking and enhancing this KPI.

Reworking on claims

A medical billing service may assign a denial/follow-up reason code to a claim as soon as it is refused or only partially paid, make the necessary changes, and then resubmit the claim as an ‘updated claim’ in accordance with payer requirements. A revenue cycle partner can help you manage your healthcare claims by working to get rid of the claim denials and rejections that keep payments from going through.

This can assist you in avoiding typical rejection factors like duplicate claims, eligibility, missing or inaccurate payer information, invalid diagnosis codes, etc.

After determining the root of the problem, your billing partner can collaborate with you to create best practices to reduce the number of denials you experience and can use specialty-specific knowledge to boost your clean claims rate.

Quicker turnaround for claim submissions

A medical billing service can help your clinic get paid more quickly by making sure claims are presented accurately up front. It can handle any clearinghouse rejections following the entry of charges and submit claims.

Providing training in best practices and monthly reporting

Your medical billing partner may impart its expertise through training sessions on subjects like eligibility and referral management capabilities or patient payment posting. In order to keep you informed about the KPIs for your practice, it will also send you periodic reports.

Summary

By enlisting the aid of a medical billing service, you could take the first step toward having a more stable financial standing. If your team is adequately trained and comprehends specialty-specific billing, your medical practice’s revenue could increase and your financial goals could be met.

Your committed staff will handle billing and back office responsibilities, evaluate daily denials and rejections, ensure that claims are properly processed, send patient statements and collection letters, and more.