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How to Reduce Loopholes in Your Medical Billing

May 17, 2016 | 2:44 pm
Published by | Krunal Popat

Generally speaking, the more complicated the system, the easier it is for loopholes to be created. That is certainly no different with medical billing services as a number of loopholes are currently present in the system. You must be accurate with your coding and use proper billing processes in order to meet compliance requirements for physicians and healthcare providers so you can improve your Revenue Cycle Management (RCM).

This means you have to keep accurate medical records, use the right billing codes, and apply the correct charges for the medical services that you provide. However, loophole still exist in this complex system that needs to be properly addressed if you are going to make the most out of collecting what is owed for your services.

Naturally, the proper monitoring as well as auditing filed claims is the first step towards maximizing the efficiency of your medical billing process. However, there are other methods that you can employ to make the system even more efficient by closing up the loopholes so that you maximize your revenue generation efforts.

Five Tips to Effective Medical Billing Process

Get Rid of Manual Documentation: Instead, automate the process as much as possible to reduce errors and increase overall efficiency. This means starting with scheduling the patient, presenting the proper forms for billing purposes, and the right application of diagnosis along with the services provided. You should double check the procedure codes, but all of this should be a part of an automated system that limits errors or mistakes made by your staff.

Improper Coding and Inaccurate Payments for Services Rendered: You should demand audits of the work accomplished and bill only for the services that were actually provided. This means that you should check for any manipulation of the billing for use of equipment or ordering supplies. Plus, you will need to be extra cautious when billing each component of a service as opposed to using one code for all the services that were provided. The more you can simplify this aspect of your billing, the better.

Double Check Codes: The easiest way to slow down your revenue generation process is allowing the wrong codes to go out for both diagnosis and referral uses. Assign someone the task of double checking and auditing the proper codes so that they can be attached to the right forms. This means for example that you should use the proper codes when a particular office visit is for consultation purposes and not as referrals. By having someone do the double checking, you can minimize the mistakes significantly.

Not Keeping Up with EOBs or Processing Denied Claims: This is a basic function of what you need to do in order to stay up with your revenue. So, keep track of your denied claims and follow ups.

Not Following Healthcare Industry Laws and Regulations: The billing coding for medical services change over time, so be sure to keep up with all the new additions.

By employing basic methods, you can substantially improve your medical billing. This means emphasizing the right training programs for your staff, automating the process so you make fewer mistakes, and using the right tools and technology so that your incoming revenue stays strong and steady.