9 Steps for a Proactive Medical Billing Strategy

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2 years ago

Isn’t it Time to Become More Proactive in Your Medical Billing Payment Strategies?

“Do you believe in miracles?” During the 1980 Winter Olympics, the U.S. National Hockey Team miraculously vanquished the Soviet Union Team (who had won the gold medal in the six previous Olympics). It has been noted that one of the chief factors to the victory, and at the end of the day, the Gold Medal, was the team’s proactive, hard-hitting approach at team practices and pre-game preparations overseen by their coach, Herb Brooks. Perhaps such an assertive, proactive approach can also work miracles when it comes to a medical practice’s payment strategies.

Let’s face it, changes in the healthcare system have produced an assortment of fresh challenges for providers and patients alike. Many facets of healthcare reform, such as the launch of more painstaking compensation models, and the everyday amendments to billing rules and regulations, trigger revenue shortfalls for providers everywhere.

Failure to remain current on medical billing rules and regulations, along with billing errors, results in U.S. medical providers leaving roughly $125 billion in uncollected revenue on the table yearly.

In 2021 and beyond, healthcare providers must become proactive and look to modernize their revenue cycle systems to drive their practices. Far too often, medical practices are unaware of any cash flow shortages until they begin hemorrhaging money.

The time is now to become proactive and revamp your collections strategy and realize the benefits of a thriving practice.

9 Steps Your Healthcare Practice Can Take to be More Proactive in Medical Billing:

Furnish staff with the correct facts.
The first step in staff possessing knowledge of the amount to collect is producing fee schedules for customary office visits, testing and certain medical procedures for your key contracted insurance plans, plus Medicare. Place the data in a table so staff can swiftly determine what a patient owes if they haven’t met their deductible.
Establish a clear collections process.
All providers need a collections process to ensure the financial health of their practiced. Establishing step-by-step approach clarifies the procedures for all involved, and it can greatly improve revenue cycles by ensuring patients are properly and thoroughly informed of their responsibilities. This leads us to our next step.
Make sure of patient financial responsibility awareness.
Medical practices need to capture revenue upfront during the patient point of contact to reduce time spent on patient follow-up and to accelerate patient payment times. With healthcare consumers having more financial responsibility for their healthcare services, it’s important to effectively communicate and educate patients about their financial responsibilities at the time of care.
Manage claims properly.
Approximately 80 percent of all medical bills contain errors, and because of how strict insurance companies are about correct billing, they’ll most likely be rejected. The cycle of submission, rejection, editing and resubmission can take weeks, often resulting in providers waiting for months before receiving payment for their services.
Because of the wasted time and effort involved in resubmitting claims, it’s important that claims are accurate and complete the first time. This involves inputting the information correctly and double-checking claims for any possible errors before submitting them.
Train front desk staff how to ask for money.
One might hear front desk staff say, “Are you going to pay your copay today?” or “I’m sorry but I have to ask you to pay today.” Training and role playing are critical to creating staff self-assurance about requesting money. Offer scripts that help staff cope with complaints and delicate matters such as what to do when a patient can’t pay.
Collect pre-procedure deposits.
Some practices have implemented the routine of giving patients a written estimate of what they will owe for procedures, etc. Many payers offer online cost estimators that estimate the patient’s out of pocket obligation based on unmet deductibles, non-covered services and coinsurance.
Offer multiple payment options.
We’ve heard more and more patients inquire as to whether they are able to establish an “auto pay” on their credit card to pay off a balance. Patient financing is another alternative that’s grown popular for patients who have $1,500+ deductibles but no room on their credit card to pay them. Usually, the practice pays a minor service fee, and the balance is paid in full and off the A/R; no more statements or staff phone calls. Plus, online pay is an opportunity to inspire patients to pay past due balances.
Offer a discount if the patient pays in full.
To resolve hefty, past due balances, have a qualified staff member talk with patients to talk over multiple payment options that involve a discount when the patient elects to pay the balance in full.
Have a plan for financial hardship.
Obviously, there will be patients who simply don’t have the funds to pay their bill. Instead of allowing that money languish in the A/R, propose assistance to patients who meet particular prerequisites, for instance, household income that is a specified threshold above the U.S. Poverty Guidelines. Think about implementing a hospital’s plan for a sliding payment scale. And for those patients who are impoverished and simply powerless to pay, don’t wait. expedite a process for “charity care” rather than letting the account bloat your A/R.

Know When to Outsource Medical Billing

Regardless of their best efforts to put into action proactive billing practices, many healthcare providers nevertheless find themselves struggling. This is frequently owing to the pricy time and labor involved in chasing down debtors, submitting and editing claims and staying ahead of regulations – duties often heaped on top of the everyday responsibilities of the office staff.

In response to the growing rules and regulations and in an attempt to slash labor costs, many practices have outsourced their medical billing to third party experts. For many practices, hiring another party to administer their medical billing is an efficient way to boost revenue and re-claim control.

Here’s a brief summary of some of the major benefits of outsourced medical billing:

Dedicated experts: Medical billing companies maintain committed staffs of billing specialists, whose only job is to make sure that claims are filed accurately and denied claims are resubmitted correctly. As such, they can focus on the minor details medical office staff will overlook in the hubbub of their routine duties.
Fast submissions: Highly qualified staff can submit claims much faster and with more attention to detail.
Greater attention to patients: Once they’ve jettisoned time devoted to billing concerns, the medical staff can better concentrate on patients.
Up-to-date standards: Medical billing companies are in compliance with the most recent healthcare laws and are obliged to stay up to date with current regulations to meet the ever-changing demands in serving healthcare providers.
Robotic Process Automation (RPA): For customers with high claim volume, robotic process automation services are crucial. An efficient and effective revenue cycle demands such service. RPA in healthcare enables organizations to optimize their business model.

Creating a proactive revenue cycle is easier said than done, but fortunately, healthcare providers now have an easy solution with Medwave. Please contact our team of professionals for details.