Medical Billing Tune Up & the Nine Step 1st Medical Billing® Check List

Indicators that suggest problems with your billing include:

• A growing AR balance;

• Claim data is not entered daily;

• Patient statements not sent regularly;

• Payment posting in error.

In some cases, approximately one fourth of all medical practice income is lost due to: lack of follow-up; missed charges; or a consistent approach to billing medical claims. Is your practice among those receiving seventy-five percent of available billing revenue?

 

Here are nine ways to improve medical billing and maintaining financial health.

1) Patient Verification 

• Verify patient eligibility BEFORE filing a claim.

• Verify patient eligibility to avoid surprises and ensure claim payment.

• Check to see if a prior authorization or referral is required.

2) Collecting Copays, Coinsurance and Deductibles 

• The best time to collect is before services are rendered.

• Use payment systems with patient credit cards on file for installment balance billing.

• Use on line payment estimators for coinsurance and deductibles .

3) Correct Claim Coding 

• Poorly coded claims pay poorly.

• Use correct modifiers to ensure payment for bilateral procedures or multiple procedures.

• Patient’s seen during the global period may need additional modifiers.

4) Daily Claim Entry 

• Cash flow is vital. Enter claims daily for prompt payment.  It is really that simple.

• When claim entry is delayed, billing is delayed.

• Additional time is required to research billing information the later the claims are entered.

• The details about missing demographics or other claim data will not be fresher in a few days.

5) Daily Claim Filing 

• Claims entered need to be transmitted daily.

• The sooner claims are received by insurance companies; the sooner they will be paid.

• Clearinghouse claim rejections need to be resolved the same day they are received.

6) Daily Claim Denial Management  

• Some claims are denied by insurance shortly after filing.

• The issues vary and can be simple coding fixes, or patient eligibility issues.

• A denied claim is an unpaid claim.

7) Daily Payment Posting 

• Maintaining accurate billing data requires real time information.

• Many claims will require billing secondary insurance claims or patient billing.

• Patient billing can represent 10-20% of account receivables and until the primary payment is posted no additional balance billing can be sent.

8) Daily or Weekly Patient Billing 

• Practice management software system that support daily or weekly patient billing is a must.

• Billing all patients on the same day once a month is too infrequent. If all patient bills are sent today, a patient seen a week ago would not be billed for another four weeks.

• The sooner patient bills are sent the more likely they will be paid.

• Statements need to be prompt and accurate. If a patient doubts the accuracy of a statement it can delay payment.

9) Review Accounts Receivables (AR) Daily

• Yes daily. You can’t get paid if you don’t ask for your money.

• Not all claims will require action but having a system in place for frequent follow up on unpaid claims is key.

• The three keys to financial health of your business . . .AR, AR, AR!

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