Strategies to Minimize Revenue Loss in Medical Billing

Introduction

Medical professionals are expected to meet their patients’ expectations and challenge preconceived notions about today’s technologically advanced, results-oriented, and digital healthcare industry. During the revenue cycle management process in healthcare, optimizing the RCM services your practice uses for its business side can help you improve the patient experience and collect funds. The practices must employ efficient medical billing strategies to minimize revenue loss.

Let’s take a look at some key strategies for medical billing collections. These tactics help prevent the loss of revenue. So, let’s dive into the ocean of medical billing to save your practice.

Medical Billing Strategies

The revenue cycle is a complex web of interdependent activities in the healthcare industry. Prior authorization of patients, explanation of benefits and verification of insurance eligibility, entry of patient demographic data, implication of procedures regarding medical practices, charge admission, medical claim processing, denial management, and electronic patient care report delivery are a few of these activities.

The inability of self-practicing physicians to use this multi-tiered reimbursement system effectively, accurately, and competently would result in financial losses for their medical practices. If these irregularities and inconsistencies are not rectified promptly, the payer may refuse to repay, resulting in a loss of thousands of dollars. The practice must address the issues, inconsistencies, and lack of clarity in the traditional reimbursement process, financial operations, and administration to enhance the overall quality of care and patient outcomes. It could be possible with the help of employing medical billing strategies, as presented in this post.

The medical billing strategies entail monitoring and reviewing performance. Monitoring account balances, collection days, and denial percentages provides financial managers with the information they need to identify internal issues and devise solutions to increase reimbursement rates and reduce delays. Performance should be reviewed every three months or once per week to improve revenue cycle management. Account-specific reports with real-time data make this possible and help minimize the loss.

Loss of Revenue

Regarding patient invoicing, medical facilities worldwide are confronting a huge challenge. Almost every healthcare system has billing, follow-up, and payment concerns. These problems may emerge for a variety of causes. Some of the problems are the patients’ responsibility, while others are the medical institutions’ fault that leads to revenue loss. Insurance claims that are denied and patients who cannot pay on their own are the two primary causes of financial damage. Lost charges can also cause the loss of revenue, delayed payments, underpayments, and rework costs. However, the revenue loss can be curtailed by employing medical billing strategies, as mentioned in the next section of this post.

Strategies for Medical Billing Collections

While the revenue cycle team handles reimbursements, healthcare professionals should concentrate on providing excellent care to patients. When the country is experiencing an unprecedented labor shortage and healthcare organizations are implementing robust denial and A/R management systems, hiring qualified personnel is important and difficult. Outsourcing accounts receivable and denial management to a competent provider of revenue cycle services like Precision Hub is one method for reducing revenue loss and enhancing financial results.

Following are the effective strategies for medical billing collections that are useful for healthcare practices.

Organized Denial Management System Implementation

The denial management process includes learning how to deal with rejection. Practices can refocus their efforts on denial prevention by implementing policies and practices that facilitate communication between front-end, mid-cycle, and clinical teams. The revenue cycle team can reduce many reasons for denials if they investigate the root cause and then implement changes to eliminate the root cause.

You can simultaneously increase efficiency and reduce expenses by outsourcing your revenue cycle procedures. Outsourcing is among the best medical billing strategies to help healthcare executives obtain the necessary coding and denial management personnel. Revenue loss occurs due to insufficient clinical documentation. Practices can use a data-driven strategy to increase their cash flow and payment rate.

Revenue Cycle Workforce Involvement

Working as a team is the most efficient method to manage the revenue cycle. Developing key performance indicators for each activity occurring at the revenue cycle’s beginning, middle, and the end is crucial. Using these key performance indicators (KPIs), you may evaluate the efficiency and effectiveness of each component process. Assisting your team in determining how these KPIs are currently doing and devising a plan to enhance them further helps minimize the loss. The practice must also find the weak areas and address them with additional tools, staff training, or personnel.

Robotic Process and Automation

Numerous business-process experts view automation as a crucial instrument for lowering the number of labor humans must perform and boost overall productivity. Based on machine learning and artificial intelligence, robotic process automation is considered an effective medical billing strategy that can replace many RCM staff’s monotonous jobs. Automation also aids in reducing the number of steps required to complete a task. Automation, if utilized properly, can significantly reduce manual labor, saving both time and money. Hence, automation is one of the best medical billing strategies to prevent loss.

Follow-up or Communication Facilitation

Most professionals concur that the submission of claims should be the most crucial aspect of the revenue cycle. After the submissions, the payers assumed responsibility for payment. Conversely, it is essential to have an open line of communication with payers and insurance agencies. There are times when insurance companies prioritize claims from certain groups and place other claims on hold. When this occurs, regular follow-ups are effective and facilitate claims processing. Regular follow-ups are among the best medical billing strategies that prevent claims from being denied or rejected for lack of supporting evidence and increase revenue.

Work on Patients Payment Collection

You should do everything possible to receive payment from self-pay patients before or during the completion of the service. Since it is difficult to determine all charges before a patient’s arrival, collecting the highest price unlikely to be returned is advisable. You can save a great deal of uncertainty by establishing clear policies and processes for collecting money and then instructing the entire staff on implementing them.

See Also: Guidelines for FQHC Medical Billing

Conclusion

Effective medical billing strategies include synchronizing procedures, forming cohesive teams, employing effective technology, ensuring corrective measures, and locating an excellent outsourcing firm. These tactics can significantly improve the financial health of your practice.

Precision Hub can assist you if you want to enhance the financial health of your practice. Our RCM experts prevent your practice from losing money by providing you with superior technology and a culture that promotes collaborative problem-solving. We assist you in averting revenue loss and setting your practice to profitability. You can reach us by calling (888) 454-4325.

Book your free demo now to see how Precision Hub can assist your healthcare practice in generating revenue.