Medical billing audit – how to streamline your billing process?

Medical billing service is perhaps one of the most significant administrative works any medical facility has to deal with, regularly. While contending with this area, one big challenge is the highly complex and ever-changing laws and regulations surrounding medical billings.
To keep the medical facility functioning smoothly in light of all these developments, it is crucial to bring efficiency in the medical billing audit. The more streamlined the process, the easier it gets for the management.
The machinations behind the medical billing process mean the revenue cycle is way more complex as compared to what it used to be when the industry did not have software automation in the mix.
The medical billing process has developed so many complications that it’s now common for bills to take months to clear. This mostly happens when a certain patient has a complicated case or has a very long medical history.
Even for the most routine care, an ongoing review is very important. This is because coordinating internal practice workflow with all the demands placed by the claims processing vendors and external clearinghouses pose a lot of challenges.
That being said, your organization still has a plethora of options to enhance the coding and billing process. This can help improve submission times and subsequently boost the first-pass approval statistics.

Clear all the collections upfront

To practice billing audits more efficiently, it is crucial to have open and transparent communication with patients. You must ensure that all your new patients are well aware of their responsibility to pay for the services they avail of. Details can also be incorporated in the surveys patients fill when they first visit the facility. The signature of patients saved in the reception will be highly useful while clarifying payments.
No patient can later claim that they were unaware of the policies. You must also ensure that all billing information is obtained from the patient on that day to support timely collection. You can also include a copy of the patient’s insurance and photo ID for your files.

Keep the patient files updated

There’s absolutely no way you can manage billings and claims with accuracy if you don’t have precise details of the patient. For this, you must instruct the administrative people to always verify patients’ demographic details along with their insurance information whenever they visit. This is important because your patient may have switched their jobs, they may have a different.
An insurer or they may have coverage from a new spouse. Rather than having your patients surprised when they see an unexpectedly higher bill, make sure you explain the entire process to them when their details are updated. Also, you should double-check all the subtle details like subscriber information and policy number, and billing address of the insurance company so that these details match with the third-party payers’ records.

Automate basic billing functions

Know that having your staff put a lot of effort into things that can be accomplished by automated systems is just a drag on your business. You’re only demoralizing your employees and leading them towards exhaustion. Start by identifying all tasks that are done on a routine basis or are repetitive. For instance, filing individual claims, generating issue payment reminders, help in choosing the right medical billing codes, and many more.

Train your employees to succeed

You’ll come across various insurance companies, and all of them will have a different set of rules. For instance, some may want you to incorporate chart notes with claims for new patients. Others might ask for chart notes only to help with follow-up care.
Work on improving your employee training programs. These programs and workshops must include components that enable billing departments to instantly search the relevant filing requirements, and access patients’ files as well. This will help guarantee that all carriers have the information required to expedite claims processing as soon as they are submitted.

Keep a track of all denials

It’s a no-brainer that having a system of checks and balances improves pass rates. Promote a culture where rejection is seen as a learning opportunity to improve the process, rather than berating the employee whenever a mistake occurs. For instance, if your organization experiences a higher than usual denial rate, you can take it as a sign that you need to give advanced training, or there’s a need to improve the scrubbing process to make the current workflow more efficient.
Training your people and providing them with adequate resources to manage accurate claim processing will only improve your organization’s processes. Get in touch with MedsIT Nexus today to avail of the best medical billing auditing services for your medical facility.