COMMON MEDICAL BILLING ISSUES & HOW TO OVERCOME THEM

Missing Patient Information

Normally the medical billing process is initiated from the start point of interaction between the healthcare and the patient. The staffs at the front desk generally gather and save the information pertaining to the patient and the services requested in order to assist the billing and collection procedures. Prior to this scheduling the appointment and registering the patient occurs. This is the foundation through which the claims can be billed and received effectively and in a systematic manner.

When some essential details are missed out during the collection of complete information initially, it affects the entire procedure causing tension to the patient and his/her family as well as the healthcare organisation in turn causing delays or issues in the reimbursement. So it is advised to verify and observe extra careful measures to gather the whole information without missing on any in a pleasant manner.

In-correct Patient Information

Careful attention is needed while the information of the patient is being entered. Even a minor change in the patient’s name or reversing the numbers in the patient’s date of birth could cause a major error.

This can be avoided by carefully checking a second time as and when the entry is being made just to ensure recording of authentic data. Or the management can use specific software which automatically prompts during the medical billing with respect to the confirmed information from the data stored.

Non-covered services

Not only that, the prime step of collecting information must confirm about the status of their health insurance and the coverage details. Respective training must be given to the front desk staff and they must be walked through the whole sensitive procedure initially. They must be advised to inquire on the benefits the patient is entitled to on every appointment and not just the first visit. This saves in clearing the doubts with regard to the services a patient is eligible for. And in some cases the relevant questions pertaining to critical information for insurance claims are not asked. Maybe the healthcare organisations could research on that criteria and include few more questions to be asked to the patients pertaining to the insurance point of view.

Case of Multiple claims

Filing multiple claims can be so annoying especially for specialty providers. In the case of Nephrologists, it is frustrating to file dozens of claims for dialysis at a single time. Keying in individually is time consuming and if one or more claims are missed out, it creates an immense negative effect and affects the workflow clinically. This can be overcome by using a mass claim creation tool.

Missed Deadlines for Filing

There are distinct filing time windows depending on the payers. While certain payers provide a two year filing window for the medical claims by an individual, certain of them give only 30 days to file them. If you miss out on the deadline to file the claim it makes you unlucky. It is definitely very difficult to appeal for those untimely filing claims.

To avoid this, a precise detail of the common payer deadlines must be prepared and kept handy in your organization team’s list. You can create a recurring pop up reminder or as an event in your calendar to notify you which helps during the medical billing.

Incomplete/Missing Documentation

Appropriate documentation is definitely needed by all the insurance providers to document any claims. In case of any missing documents, they will easily reject the claim and send it back to you. This causes the headache of re-submitting the claim after collecting the necessary documentation and disturbs the revenue cycle management.

This can be avoided by making sure that proper training is given to the staff in recognising whenever a need for documentation of the specific medical requirement arises. It is advised to have an update billing software which would list the necessary documents while processing the bill.

Failure to make prior discussion about the payment

To discuss about money with the patients for the services required is not an easy task. The exact costs involved must be clearly communicated to the patients. If they fail to do so, it will cause an unnecessary commotion at the time of billing which might have an adverse effect on the revenue cycle. Hence a wise strategy ought to be followed where the organisation does not give the choice to the patient but allow them to select between the options for mode of payment.

Modes of Payment Availability

Instead of compelling to pay and settle bills by cash right away, the healthcare organisations must ensure to widen the options for making payments which can include online or credit card payments. Many find UPIs as a convenient and efficient mode to make the payments. So the healthcare organisations must be flexible to these newer and effective paying methods.

The Resources

In order to maintain a high number of clean claims and maximize the revenue cycle management, it is essential to use relevant medical billing resources. Right from the customer care, to educating the patient, optimum quality software or tools for productivity clearly involves the clever practise of medical billing resources rather than being left to follow the traditional routine of doing things.

We are obliged to be of service in taking care of the patient’s health. But we should also make sure that sufficient care is taken to offer them proper steps to help them deal financially too. These small practices we observe in medical billing saves a lot and lend a helping hand wherein enhancing the revenue cycle management.

Medical billing outsourcing companies

While most of the healthcare organisations practise medical billing using their in-house staff, it is observed that complications arise regardless of the staff being skilful or talented. And there is a constant struggle owing to the limited time available.

In order to attain a successful medical practice, following a conducive plan with regard to the financial health is vital. With the help of a professional medical billing outsourcing company it provides the organisation with well organized and precise medical billing. This avoids the common hurdles and errors in medical billing, giving great relief to the healthcare organisation.