Let’s admit it: Claims denial is a common challenge that many healthcare practices face. According to a Medical Group Management Association report, there was a 69% increase in denials in 2021. This, paired with the coronavirus pandemic, places significant financial strain on many clinics, institutions, and providers. Therefore, it may be time for your practice to conduct an internal review and overhaul of your medical billing processes. Managing claims in a timely and orderly manner would benefit all providers to maximize their revenue, regardless of size. These are four great tips on how you can reduce claims denial rates.
Healthcare organizations should take the time to double personal information and details with patients before performing any form of medical service. Unfortunately, while seemingly common, the importance of this practice can often be overlooked by many organizations. However, this is key to reducing the rate of claim denials as it helps you have accurate information on hand, allowing you to work efficiently and submit your claims timely.
If software tools are accessible and within your organization’s budget, you can integrate them to optimize the efficiency of your medical billing processes as it saves the time needed to verify the eligibility status of every patient for their insurance coverage. Most importantly, it is always critical to communicate transparently and clearly with every patient to avoid misunderstanding. Additionally, it is good practice to consistently inform them of their responsibilities in timely payment. These could be through different channels such as EDM (direct electronic mails), your organization’s website, and at physical touchpoints during every visit.
You may not know it, but the implications of having undertrained or insufficient staff could be costing your healthcare practice. During their onboarding period, all newly hired employees in the billing department should undergo advanced training to understand the ins and outs of medical coding and billing. Experienced staff should also be regularly updated on the new coding standards and practices to keep them up to date and reduce the likelihood of claims denial.
While it can be difficult for a company to see its faults and errors objectively, conducting regular internal audits throughout the year can be beneficial to helping your staff stay on top of their roles and responsibilities. In most cases, many companies lack the expertise or foresight to identify spaces for improvement and may need third-party companies to provide constructive feedback to improve their billing processes.
With the expansive range of technology and software developed to automate medical billing processes available today, your organization should take advantage of the opportunity you have to upgrade your systems and programs to stay up to date with the latest medical coding standards. Many organization leaders tend to be worried about how the downtime that comes with upgrading their networks could affect their productivity but fail to understand its long-term benefits. Your healthcare practice should look to invest in well-established software that specializes in managing claims denial management and can optimize the efficiency of claim submission.
As a medical billing and revenue cycle management company, we know the challenges of having to stay up to date on the latest medical billing codes all too well. We also know how easy it can be to have a small error derail the entire medical billing process. That is why we are here for you, to guide and help you at every step of the way. We are committed to providing contemporary and innovative solutions to optimize your medical billing processes, from charge entry services to claim scrubbing to patient billing services.