Optimizing Healthcare Revenue Cycle Management
Medical billing is the backbone of healthcare revenue cycle management, but most doctors experience significant challenges with accurately billing payers for services they perform and efficiently receiving payments from payers. The entire staff at small & medium sized medical practices is focused on running a smooth practice, and medical billing especially rework of rejected and denied claims, takes a backseat.
Effective medical billing is essential for optimizing healthcare revenue cycle management and reducing days in accounts receivable (A/R). Working with a good medical billing partner can help increase payments from payers and improve patient collections.
The medical billing process starts with patient registration and ends when the provider receives full payment for all services delivered to the patient. Generating and managing claims can be a complex process but one-third of providers still use a manual process for rejection and denial follow-ups (1). Automating billing and claims management by working with a medical billing company can help providers submit clean claims in a timely manner and reduce reimbursements held up by rejections and denials. Medical practices that have a great medical billing company as a partner are able to better identify root causes of denials, reduce write-offs, and improve A/R.
Eligibility issues are a major reason for claim rejections, and about eight percent of claims are rejected because of eligibility problems (1). Reducing eligibility-related claim edits starts with getting accurate information up front with patient registration. Other reasons for claim rejections and denials often involve inaccurate coding and using the correct modifiers. A coding specialist can verify which codes can or cannot be billed together, while making sure the appropriate modifiers are in place. A good medical billing partner will work with the front office staff to ensure accurate information is collected during patient registration, has a laser focus on collections, and will reduce rejected claims to a minimum.
s2n2 Medical Business Solutions is a medical revenue cycle management company that prides itself on less than 2% claim rejections and denials. www.s2n2solutions.com