How Can I Enhance My Medical Claims Billing Process?

While we should expect technology to revolutionize the way we handle administrative tasks, the bureaucracy and authoritative regulations that come with it have also made the medical claims billing process more complicated and confusing than before.

The act of balancing your patients, vendors, and clients’ expectations paired with the never-ending challenge of coordinating internal workflows could only spell for stringent work processes that constantly require meticulous oversight and constant reviews.

As a result, many bills can take weeks and even months to finalize, clear, and reimburse the patients. However, there are several measures you can take to enhance the medical billing process.

Update Patient Files Regularly

One of the most integral steps of ensuring punctual and timely medical claims billing and submission is having the latest details of your patients on hand at all times. Staff at your healthcare practice should be instructed to constantly verify their personal information, even mundane details such as insurance policy coverage, billing, residential addresses, and occupation. They should advise patients on their responsibility to keep the clinic or institution updated on any changes in their personal details. More importantly, maintain a clear communication channel with the patients and explain the medical billing process to encourage better cooperation and coordination. A rule of thumb is to ensure that their details match up with the records of the insurance companies.

Exercise Tighter Quality Control

One way to boost efficiency is to eliminate errors during the submission process. Denials and claim errors are critical and can be costly to the financial strength of your healthcare practice. Therefore, it is important to use conventionally accepted accounting practices and keep a good record of payments to improve submission accuracy. One way to do this is by creating deposit logs that include the patient details, account number, invoice number, referral reference number, and total amount to expedite the billing process. In addition, this makes it easier for the third-party payer to approve the claim.

Incorporating a System of Checks and Balances

The top reasons for medical claims denials are insufficient supporting documents, utilization of wrong service and equipment codes, and lack of proper credentials by the physicians. To increase your first pass claim submission rates, you can incorporate an internal system of checks and balances in your billing processes.

For instance, when filing for medical insurance claims with the billing department, it might be helpful to send medical/chart notes written by the physician to verify the eligibility of the coverage. In doing so, staff should also receive advanced training during the onboarding process to optimize productivity. Track every denial code and communicate with your staff regularly to review the coding protocols and eligibility verification process.

Capitalize on Automated Billing Technology

One way to increase the efficiency of your billing processes is by automating repetitive and routine operations such as issuing payment reminders, selecting of right medical billing codes, and individual claims filing. With how far technology has evolved, this is an opportune time to shift your billing processes to be fully digital. As a result, staff members will be more dedicated to providing your patients with higher-quality, more personalized services. In addition, a third-party revenue cycle management like KR Billing Solutions can help prioritize and work medical bills regularly to optimize and boost efficiency.

Maximize Your Revenue with KR Billing Solutions

At KR Billing Solutions, we understand the struggles that come with claims denial and how it can significantly impact the financial stability of your healthcare practice. Therefore, we are committed to providing our clients with the most innovative medical billing processes to maximize efficiency. We specialize in many fields, including Opthalmology, Optometry, Gastroenterology, Physical and Occupation Therapy, and more. While we believe that automation is a key part of expediting medical billing, KR Billing Solutions take our time and dedicate a personal touch to the work to help you run your practice smoothly.