Healthcare revenue cycle management is a complex network of processes with many different departments and stakeholders involved. Having an efficient and healthy medical billing process not only makes it easier on everyone involved, but it will get you paid!
Navigating through the challenges of medical billing may seem complicated, but it is crucial for a practice in order to reduce their days in accounts receivable. Get through the challenges by understanding these four most frequent medical billing issues.
1. Not Capturing Patient Information
Starting with complete and accurate patient information sets the stage for efficient medical billing. The staff at the front desk are responsible for making sure all information that is needed is collected and that they are checking the given information for accuracy.
Avoiding a return on a claim submission starts with this important piece – not only getting correct and complete information, but also verifying health insurance and coverage. According to a survey by ClaimRemedi, 80% of submitted claims were rejected due to issues with the insurance eligibility.
Make sure to enforce best practices to the front-end staff on how to correctly verify insurance and what information is needed. Retraining on a consistent basis can help to keep these important steps top of mind.
2. Not Informing Patients about Their Financial Responsibility
In the 2016 open enrollment period, about 11.4 million enrollees selected a high-deductible plan. This caused a significant shift in financial responsibility to patients. Although patient responsibility has increased, providers only expect to collect 50% to 70% of a patient’s balance.
To anticipate a higher rate of collection from patients, practices should let patients know what they are financially responsible for prior to their service.
3. Using Manual Claims Management Processes
According to a HIMSS Analytics report, one-third of providers are still using a manual process for denials management. Handling pieces of the revenue cycle processes manually may lead to inaccuracies, increasing days in A/R.
The report also found that practices that utilize a vendor for their revenue cycle were able to find and understand root causes of denials and were able to resolve issues and decrease the number of write offs.
Automated solutions help to improve the healthcare revenue cycle as there is more insight into analytics, which can help an organization improve on KPI’s.
4. Inaccurate Coding
Inaccuracies in coding can result in an increase in claims denials, causing a logjam in a claim’s journey. Although ICD-10 implementation was much more effortless than anticipated, organizations are still faced with coding errors, with the top coding errors being incorrectly applying seventh characters for certain codes, not using procedure codes correctly, and more.
Taking the time to consistently train staff on ICD-10 coding updates can assist with alleviating coding errors.
Read the original article from RevCycle Intelligence here.