Billing Issues That Affect a Practice’s Revenue Cycle

Billing Issues That Affect a Practice’s Revenue Cycle

By intellircm 17th Feb 2023 Blog

Revenue cycle management refers to billing for services and collecting revenue for healthcare service providers. Optimizing the billing process is a crucial protective factor to sustain a practice. Billing issues create problems at various points in the revenue cycle, but knowing where some of the most common sticking points are will better inform staff on how to avoid them.  Keep reading to learn about some of the biggest billing challenges facing medical practices today and how to overcome them. 

4 Common Medical Billing Issues

The billing process comprises a necessary part of any functioning medical practice. Often, it can present challenges that may seem intimidating or confusing. Paying particular attention to the items on this list can save you from making mistakes that could cost delay or loss of revenues.

1. Not Informing Patients for their Financial Responsibility

Many people face higher deductibles and increased financial burdens these days. Communicate payment expectations explicitly with patients to avoid any misunderstandings. Convey the deductible amount, co-pay, and an approximate co-insurance figure. Sending statements can effectively inform patients of their responsibility in a friendly and professional manner. Send them as soon as possible and follow up if needed to prevent backups in the revenue cycle.

2. Incomplete or Incorrect Patient Information

Even before a patient’s visit, essential data collection can occur. Information like basic demographics, insurance status, primary care provider, or relevant copayments expedites the process. Blank fields in a patient’s profile can lead to delays or rejections or denials  in the revenue cycle. Standardizing an intake process proves the best practice method for ensuring thorough and accurate patient information and avoiding rejections or denials which can pile up on the aging/accounts receivable.  Ensure the practice’s staff receive proper training on recognizing which documentation is necessary from patients and that they review everything after collecting and before submitting. 

3. Inaccurate Coding and Billing Challenges

Proper medical coding allows for faster, errorless and deserving revenue generation. An occasional mistake is inevitable but minimizing errors is crucial for the continued success of a practice. Securing reimbursements depends on correctly reporting procedural codes. Some commonly reported coding errors are: 
  • Upcoding: Billing for a more intensive or complicated procedure than the one performed.
  • Undercoding: Not billing for the entirety of treatment or services provided.
  • Unbundling: Coding for separate procedures rather than a whole group.
Avoiding mistakes like these mitigates potential billing risks. Accurate coding is crucial for minimizing health reimbursement issues. To prevent these from happening, use up-to-date coding references and make them easily accessible to staff. 

4. Inefficient Payment Posting

Payment posting gives an overview of a practice’s day-to-day financials. A streamlined posting system has a crucial impact on the financial health of your practice. If payment posting is delayed, so too is processing and balance collecting. A solid payment posting system catches trends behind denied claims, non-covered services, and prior authorization issues.  Ensuring proper billing and revenue recognition records sets a practice up for good financial health. Take stock of payment posting to maximize reimbursements and overall revenue. It can also allow for decreased labor costs.

Summary of Medical Billing Issues Affecting Your Practice

Errors in medical billing often result from common mistakes in data entry procedures, which impacts the efficiency of a practice’s revenue cycle management. Luckily, many of these mistakes have simple solutions. Whether there are hang-ups in informing patients, collecting information, coding errors, or payment posting issues, no problem is insurmountable. If implementing these solutions independently seems daunting, partnering with a company with expertise in helping healthcare practices achieve their goals can be helpful.  IntelliRCM provides IT services, litigation support, record retrieval, e-discovery solutions, and data management for medical practices.  For assistance increasing revenue, contact our experts via phone at +1 (917) 779-8700 or on our website.  

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