The rules and regulations surrounding payer reimbursements are constantly changing. Payer’s are in the business of making sure you don’t get paid so it is essential that providers and their staff “cross their t’s” and “dot their i’s”. Below are a few tips to help increase payer compliance and reimbursement.

1. Technology

The use of electronic health records systems (EHR) such as Practice Fusion and paperless claims software such as NueMD can improve the efficiency of your medical billing process. The use of software provides for better accuracy in documentation and coding. This allows providers to keep up with the constantly evolving rules and regulations for Medicare, Medicaid and other commercial insurance plans. EHR and Billing software allow for faster charting, billing and receipt of payments which decrease the time your funds are in A/R.

2. Verify Benefits

Always verify patients’ benefits before every visit and/ or procedure. Doing this ahead a time will allow your staff to collect the appropriate copay’s and deductibles during the visit and also avoid costly insurance denials due to ineffective benefits.

2. Patient Information

It is important to verify patient information with each medical visit. This information includes a patient’s address, insurance card, phone number and social security number. Having this information is critical to the collection process, as sending claims to the wrong insurance company or patient can result in unnecessary delays. Up-to-date patient information is also important in the case of delinquent payments, which would be turned over to a collection agency.

3. Communication

At the time of service, patients should be informed of copays and deductibles related to their medical visit. Billing information and terms of payment should be easily visible and accessible to patients. This could eliminate any confusion about a practice’s billing procedures. It might also be more efficient to collect smaller payments, such as copays, at the time of the visit to avoid unnecessary statement fees.

4. Reporting

One of the best ways for a medical practice to improve its billing process is data mining. Accurate data mining can provide insight on billing and collection trends. With billing software systems, medical practices can develop unique reports that provide information on billing errors, underpayments and revenue cycles. Analysis of the data can help to optimize medical billing management and staff productivity, and eliminate payment errors.

5. Collections

Define a set list of rules for medical collections. Allow patients a few chances to pay or make arrangements for the collection. However, if any forms of communication are ignored, it is in the best interest of your practice to turn over the claim to a collection agency. For this reason, it is important to have the most up-to-date patient information.

Healthcare reimbursement is often a tedious process. Thus, it is necessary to understand ways to make the process more efficient to ensure a healthy revenue stream for your medical practice.

Links:
Clientfit Medical Billing Service
Practice Fusion Consulting