Medical billing services were considered a very easy job for a long time, but now, this notion is changed. Healthcare organizations are now well aware of the importance of a proper team for compiling claims and managing the revenue cycle.
The payment process doesn’t only involve a billing team, but it also revolves around clearinghouses, insurance companies, clinical staff, and others.
Moreover, the front desk team is required to collect necessary information, collect revenue, and upfront co-payments from patients. The clinical staff makes sure that all rendered services are documented with accurate codes and billing statements. Meanwhile, another team collects revenue from insurance companies and handles the denial management and follow-up services.
Thus, there is a large team required for several steps of medical billing and coding, and professional medical billing companies have dedicated resources for each task.
Here’s how it goes.
Revenue Cycle Management Starts from Competent Front Desk
As briefed above, the medical billing process doesn’t start from documenting procedures and translating them into codes. The process starts long before this stage. It is up to front desk managers to collect personal and insurance-related information, which is predominant for transparency of operations.
The staff also requires information about the hierarchy of insurance plans such as primary and secondary. This way, medical billing services ensure reimbursement of services, which may not be included in the primary healthcare plan. Without having the exact knowledge, physicians can leave money on the table.
Taking care of reminders, setting appointments, engaging patients are also part of their job description. Discussing financial matters with patients and receiving copayments and deductibles is also done through the front-desk staff.
Therefore, front-desk staff and medical billing companies work alongside each other.
Clinicians’ Role in the Medical Billing Process
Nowadays, clinicians’ tasks don’t include just treating patients. They have been extended to keep an eye on the accounts situations and the codes and the billing updates for revenue cycle management. Healthcare services are already a mental stretch, dealing with other’s matters vigilantly simply is impossible. Even if physicians take charge of compiling claims by themselves, they often can bypass errors, and their denial management system is generally poor.
That’s why modern healthcare organizations choose to outsource billing and coding services.
Although the majority of the work is done by medical billings services, physicians should be aware of the documentation status and requirements. They should know about denial management and follow-up services. This builds an understanding and environment for clinicians to adopt strategies that best benefit them as well as assist in offering quality healthcare to patients for medical billing staff to generate higher revenue for them.
Now, you may have understood, a professional medical billing process requires a well-connected framework for efficient earning.
No doubt, a major portion of tasks is done behind closed doors such as interacting with payers and clearinghouses, managing appeals, discussing payment plans to ensure claim’s acceptance. But, there are other operations, which are of equal significance and poor performance in those tasks can risk revenue and reputation.
Given below are some tips to simplify operations and maximize performance in the billing sector.
Gather Personal Information Beforehand the Patient’s Visit
When a patient makes an appointment, the front desk staff should be ready to collect all the data. The information can be collected via online portals, directly on phones, or via email.
Verify Eligibility Beforehand the Patient’s Visit
Medical billing services should verify insurance plans and clarify payment rules beforehand of the visit to avoid any inconvenience or loss afterward.
Collect Co-payments at the Front Desk
Establish strategies that allow patients to pay face-to-face or via card for transparent cash flow. If you enforce rules, the more you have a detailed payment structure, the fewer problems you’ll have to receive reimbursements.
Offer Multiple Payment Plans/Methods
Access to flexible payment methods allows for easy and rapid payment. Billing services can also offer installment plans to patients and train the staff to comprehend and communicate needs.
Do Regular Follow-ups
Many of the patients may not be able to pay upfront and the installment plan is for them. But just giving a payment option is not enough. Staff should make a habit of timely follow-ups and reach out to people with an outstanding balance.
The practice survival depends upon the efficiency of medical billing services, and collaboration among all parties is required to achieve end goals. Certainly, handling billing and coding operations is not an easy task, and hopefully, this article would have cleared any misconception related to such a strong pillar of the healthcare system.