Medical Billing Tips for Small Practices

Medical Billing Tips for Small Practices

When you think about medical billing for small practices, the first thought that pops up in your mind is that it can be daunting, frustrating, tedious, and full of errors. However, if you think of the bright side of running a small practice, you can realize that it is the best way to build close relationships with your patients (whether ongoing or ex). You can also be specific with their diseases and give them personalized care and treatment. This whole experience makes things better for you, for your patients, and emits a positive vibe in your community.
However, where there are upsides, there are some downsides to running small practices. These downsides come in various physical, mental, and financial challenges. One of which is handling the medical billing for your small practice.
Struggling to handle medical bills and processing claims commonly results in claim denials. If we consider the stats, almost 30% of the medical claims in the US are denied right after the phase 1 submission.
Denied claims mean that as a practice, you have to submit them again to get reimbursement. This comes costly as it is estimated that a single rejected claim, if corrected and sent back to the payer again, costs almost $25-30.
Medical Billing Tips for Small Practices
The good news regarding small practice medical billing is that you can implement a few tips, tricks, and strategies in your daily medical billing process to avoid such problems altogether. Here are some of the tips that you can start applying right now:

Correct And Updated Demographics

The process of medical billing initiates from the patient’s data. This includes their name, gender, phone number, address, and anything that can be jot down as a patient’s entry. However, some small practices’ medical billing department neglects the importance of such vital data. This causes errors when all this information is put on the record. And when this information is processed, that same faulty data gets processed in the medical claims and gets rejected.
The solution for this issue is to be extra careful when recording the patient’s demographics. Let the patient be clear about this information. They should know how important it is to record this data carefully and accurately. Once done, it’s best to give it a second check and see whether the data is accurate and best to the patient’s knowledge to avoid future billing conflicts.

Insurance Plan Verification

The next thing that immediately follows up after confirming the demographics is identifying and confirming the patient’s insurance plan. In other words, whether their insurance plan covers the treatment they’re currently getting (or about to get).
Also, you must tell your patient how much copay they should pay for their treatment. You must not assume your patient knows about it already. And that’s why it’s best to tell your patient about it.
Also if they don’t have insurance, you must guide them properly about how they can process payments from their pockets. This also means you communicate clearly with your patient for such sensitive matters.

Carefully fill in The Claims

Now that you have accurate information regarding patient demographics and insurance plans, the next step is to carefully fill out the claims. Although this step is obvious, it is crucial to mention it here because if the payer rejects your claim for a simple spelling mistake, that rejected claim can take weeks before you can resubmit it.
If you dive into the details of this denial process, you can realize how negatively it affects your medical cash flow. It can cause revenue delays (or even losses) and your whole focus can be disturbed due to such billing errors.
This means your patients won’t receive proper care and treatment from your end, which can negatively affect your whole career as a practitioner.

Double-Check Claims For Errors

Studies show one of the major reasons for claim rejections is incorrect medical coding. Since all the ICD codes look very similar to each other, it is fairly common that error(s) pop up before, during, or after submission.
This is the reason why it’s critical to double-check the claims you send for processing. For faulty coding, different tools can be used, called “claim scrubbers”. These tools can help you identify and review each claim before sending it to the payers. However, since claims scrubbers are only just software, it is better to have medical experts manually take care of such error inspection.

Set Up Rules And Regulations

Handling medical processes can be chaos if not done via the proper system. That’s why you should consider establishing proper rules, regulations, and codes of conduct for your patients, payers, and processes.
For example, if the insurance company doesn’t cover the patient’s treatment, you must convey the payment rules and regulations to the patient. This is to ensure payments are done within time and not out of time (or with unnecessary delays). In the same way, you can set up rules for late & non-payments. This way you can ensure a constant flow of revenue stream into your practice without any unnecessary hindrance.

Set Up A Streamlined System

As mentioned above, it’s crucial to have a proper system that deals with literally anything that happens in your practice. This includes several things you foresee and implement for smooth billing and processing.

Trained Medical Staff

Normalize frequent training for your medical staff so they give their best to your practice. This is a healthy investment you can make in your current employees to reap fruitful results in the future.

Proactive Approach

Normally the time frame to re-submit the claim is around 30-60 days. However, some practices delay this processing. As a result, most claim processing gets past the deadline, resulting in further delays and rejections. To avoid this mistake, it’s best to process claims in time and utilize a proactive approach to make things fast.

Active Tracking

When you submit the claim in time, the next best thing you can do is to track the progress of your claim and understand which stage is it currently at. You can see which stage takes the longest time to process. You can also track where errors occur mostly. This is how you can identify and fix those errors altogether.

Advanced Software

As technology, especially artificial intelligence (AI) progresses, it's best to take advantage of this technological revolution. You can actively adopt modern tools and software and readily apply them in your practice where they’re needed the most i.e. medical billing, coding, and processing.

Outsource Billing To Experts

One of the best, most fruitful, and most beneficial ways to run your medical billing sector is to outsource your medical billing and coding to an expert company that knows how to do medical billing efficiently. Expert medical companies like MaxRemind get your billing done by a group of medical billing experts.

That’s why they have such a low medical claim rejection rate. And that’s why the practices that work with them, never leave them (MaxRemind has a 100% client retention rate). This shows how sincerely MaxRemind puts its efforts into your practice to help you make the most of it.

Moreover, with MaxRemind onboard, you get plenty of other services like healthcare revenue cycle management, electronic health records (EHR) for small practices, and much more.

how to streamline medical billing

Conclusion

These are some vital tips and tricks you can readily apply in the medical billing and coding for your small practice to save time, and effort while making more revenue (even from the existing patient base). Although some tips depend more on how much money you invest beforehand, you can still implement other practical strategies mentioned above to streamline your medical process, making it more efficient & reliable.