Medical billing is a complex process and everything needs to run smoothly; if your billing system is disorganized or disrupted, the result can be far less cash flow than you anticipated. Some of the most common medical billing problems can derail the payment process and could even prevent you from being paid at all. From simple disorganization to failing to follow up on aging claims and even piling too many responsibilities onto your billing staff, here’s what to watch for if you want to improve your billing process:
1. Failing to Follow Up on Claims
Outstanding insurance claims with some kind of issue won’t resolve on their own. When you neglect these, you’re leaving money on the table. Aging reports can help spot these lingering claims that have been submitted but that have payment delays so you can follow up on them. Whether a claim wasn’t transmitted properly or there is a problem with it, if you don’t follow up on missing payments, you’ll never know what is going on. Failing to track and follow up on older, unpaid claims directly impacts your revenues and profits.
2. Accepting Clearinghouse Reports at Face Value
Those unread reports can add up fast, making what should be a quick and easy task one that can eat up an entire morning. You need to check your reports without delay; they often harbor problem claims and issuers that won’t resolve until you take action. The longer it takes you to address the problems, the more likely it is you’ll end up without payment at all. Commit to checking reports daily and identifying and fixing claims problems immediately so you don’t overlook or lose an item that needs attention.
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The number one problem for most practices is simple disorganization. The billing system is chaos and claims are not being filed in a timely manner – or at all. Since most payers have a time limit, delays are expensive for providers; when you eventually find and submit your claim, it could be denied due to timely filing. Filing claims and denials in a timely manner, ideally right at the date of service, can help improve cash flow and ensure you don’t miss out on revenues.
4. Employee Training Issues
Medical billing is complex, and employees who can’t comprehend the components of an EOB could be costing you money. Your EOB lets you know exactly why you were not paid as expected or even why your request was declined. Your billing employees need to be able to not only identify the problem, but take steps to correct it and resubmit for payment. If your team does not fully understand the claims process, there could be unwarranted denials or errors that are costing you revenues; they need to do more than just accept the check; they need to carefully review the EOB for errors and omissions, too.
5. Making the Billing Team Multi-task
In many medical practices, the person charged with handling billing also gets assigned many other administrative tasks and even works at reception when needed. If the person handling your billing is overwhelmed with work or does not have clearly defined responsibilities (that all focus on billing), then some of the most important tasks your office has (after patient care) are being given less attention then they deserve.
Your medical billing person in-charge needs to put sending and handling bills and revenues first; these critical tasks ensure your practice has the cash flow it needs for regular operations. Medical billing is not always a clean, straightforward task, so if you make your primary biller multitask and handle other things as well, your cash flow could slow to a trickle.
Billing takes time to learn and time to implement; making sure your team is trained and aware of the most common issues can prevent revenue loss due to improper or untimely filing. Simply being aware that you need an organized system and that your billing team needs to put actual billing first can drastically improve your cash flow and bottom line.