It is the primary responsibility of the front desk staff to check in patients, collect copays, and verify the insurance eligibility of a patient. But there is a lot more to the story and out of sight. However, it is the backbone of the physician revenue cycle management. Much of the heavy lifting for physician billing services and collection is done at the back end of the medical practice. So it is even the most important aspect to have a deep bench of talent.
Here’s a quick guide that offers the key strategies for financial management and support services for physician billing services. With the following 6 key strategies, you can get your billing team to bring the best game to your physician billing services and collection effort.
Provide consistent training to the medical billing team
Medical billing and coding are the ever-changing aspects of medical practice. Government and payer policy changes can occur more frequently for the medical billing and coding guidelines than anything else. Therefore, physicians should train their medical billing staff in order to set up payment plans. Often, the front desk staff will explore the need to set up a payment plan with self-pay patients or patients with an outstanding balance.
But the physician billing services contribute the most to the actual arrangement of the physician’s office. It is crucial that these plans should be consistent and fair to all patients. Physicians would need to have one or two people in their back-office staff who know how to correctly handle physician revenue cycle management. Ongoing training of the medical billing staff will also alleviate the pressure on the front desk to make decisions about waiving payments and also provide insights into better decision-making.
Reconcile encounter forms and file claims promptly
Physicians should build patient portals where they can ask questions about the services and seek clarifications from the service providers. The medical billing staff should be aware of the appropriate modifiers and their appropriate usage. It is imperative for reliable physician billing services to make sure that medical billers are submitting clean claims. As a result, clean claims get paid at the first attempt and stand up to a potential audit.
Analyse insurance denials
Physicians should have a proper system in place to analyse denials and develop processes to reduce them in order to prevent revenue leakage. They should check whether there is a misuse of modifiers, denials related to medical necessity or outdated codes are used in it. If the medical billing staff would strive to track the denials and see where they are making mistakes then they can spend time rewarding physicians’ practice with higher and prompt payments. Similarly, if the physician’s staff must adopt an effective process for physician billing services in order to rectify and refine the denied claim promptly.
Consistently follow up on accounts receivables
It is the primary responsibility of medical billing staff to regularly run insurance reports and review anything more than 60 days old. You may have called the payer in some cases but most claims pay within 21–30 days of the claim submission. If this is not the case then it is the need of the hour to investigate the actual reason behind ageing account receivables.
Regularly conduct patient flow analysis
Time is the most valuable asset for any medical practice and anytime if there is a patient flow problem then it can cost the practice. The office manager or practice manager should analyse the patient for all of the medical practitioners, identify key problems, and find efficient ways to streamline the whole physician revenue cycle management process.
For instance, you might perform an analytical study to estimate the pattern or schedule of patient flow. This study would help analyze how long it takes patients to complete the check-in process and be placed in the extra room. It will help you monitor and streamline processes at the front desk staff. A shorter check-in process can improve patient satisfaction and help physicians to prevent falling behind their payment schedule.
Dedicate a team to follow up on patient balances
Your front desk should make sure that patients are aware of their balances and copays. Someone in the administration office should call the patients and remind them of their payment responsibilities. Therefore, many medical practitioners tend to outsource physician billing services. So a professional and dedicated company regularly follow-up with their payment schedule, aggressively follow-up all the claims, recover the outstanding dollars (account receivables) and make calls to the payers so long as follow-ups are conducted on an ongoing and regular basis. In this way, physicians become confident when their back office takes tasks seriously and process claims smoothly throughout the practice. When that happens, most of medical practitioners have said that they observe a significant bend in the curve of revenue generation. In that case, a reliable physician billing company becomes a bonus for their practice.
James Wallace did his degree in psychology at the University of Hertfordshire. He is interested in mental health, wellness, and lifestyle.
