By intellircm 17th Feb 2023 BlogRevenue 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 IssuesThe 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 ResponsibilityMany 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 InformationEven 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 ChallengesProper 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.