Medical Billing Software: Top 5 tips to improve the billing experience in your practice
In this present expeditious world, you need to keep pace with the race. Even with utmost care and dedication, mistakes happen as they are unavoidable. Why we are telling you this here, is because the most important thing for a healthcare provider is to get paid for the services delivered by them. It is the most crucial system to handle, and the problems and difficulties faced by providers in handling the claims can make them go crazy. Here, in this article, we give you the top 5 tips you can practice in your medical billing to ensure good thrust in your business.
Let’s learn basics: Meaning
Medical billing is a process that involves third parties like patients or insurance companies. It is a payment practice used by the United States Health System. This deals with the submission and following up on claims with the insurance company, to receive payments in contemplation of the service extended by the healthcare provider to their patients. Medical billing here, translates to the term, “claim”. These are billing invoices for the service rendered. The entire process of the billing cycle is also called Revenue Cycle Management. Now, Practices that interact with the patients for providing services under HIPAA, must send most of the billing claims via electronic means.
The designated medical biller needs to do a follow-up on the claim and make sure that the provider gets the reimbursement for the service contributed by them.
Some people may tend to get confused with medical billing and medical coding. They are two different concepts. Medical billing deals with billing claims to insurance companies and medical coding is the reviewing of clinical statements and assignment of standard codes.
Types of Medical billing
There are mainly two types to it. One should know the difference to decide what kind of billing they need to follow in their practice.
1. Professional billing
The medical billing task is not followed the same throughout all types of medical facilities. Traditionally, claims were submitted in paper format. The administrative desk carries the functions like greeting patients, collecting their information, registration, etc including medical billing.
Here, professional billing helps them with billing claims for the service rendered by the physicians, other non-stigmatized providers, suppliers, etc, for both in and out-patients.
Professional charges are billed on a CMS-1500 form
This type of billing often performs both medical billing and coding.
2. Institutional billing
This type is used by hospitals, nursing facilities, institutions that deal with both in and out-patients. Institutional billing is used here, for billing the claims for services provided. This includes lab services, radiology services, the usage of pieces of equipment and supplies, and so on.
Institutional charges are billed on a UB-04 form.
It performs billing and sometimes collection, but not coding.
The other three types of medical billing are,
1. Open System:
To understand easily, let us start with an easy example - Electronic Health Records. The open system allows movements across healthcare providers, professionals, facilities, institutions, etc.
As it is open to all, It is not preferred and recommended to use this type of system, because it does not always comply with HIPAA’s privacy policies.
2. Closed System:
Here, the best example is Electronic Medical Records. This system, according to its name is closed. It does not allow any kind of transfer and doesn't allow collaboration with other doctors or institutions.
3. Isolated system:
An isolated system, true to its name is completely isolated from physicians, healthcare facilities, and practices. This uses Personal Health Records which are accessed by the patients alone. Hence they are not legally replaceable by official health records, they are not commonly suggested or used.
Improve your productivity by implementing these top 5 medical billing tips in your practice to overcome the hurdle
Stop yourself from thinking too much. Don’t make yourself worried which leads to a fall in your performance. We are here with the top 5 tips that you need to follow or adopt while making your medical billings. These are not so complicated, so let’s jump into this without any delay.
1. Collection process: Make it clear
It is necessary to follow a properly planned collection process while making medical billing. Make sure you are collecting valid data from the patients and let them know about your terms and conditions for excluding future complications.
- Collect as much information you can get from your patients regarding their name with correct spelling, e-mail, contact number, address, workplace, and so on, and a valid photo ID card is a must.
- To reach the patients in time, you need to make sure their contact numbers and address are updated frequently. Please don’t hesitate to do this. It may seem to be a small and simple task but it changes everything.
- Let your patients know what you are expecting from them regarding the payment of their debts. Include some easy-to-understand terms and conditions without bragging. And explain this to them if needed.
- Let your patients know about the available payment plans and options for them. Whether options for using credit cards, cash or checks, etc. are available.
- Prepare reminder letters and e-mails for sending them to the patients when their bill comes due, is overdue, or is about to send to collections. A paper-based letter weighs more than an e-mail in the case of stubborn patients.
2. Proper claim management: Including the basics
In the billing department, the process of submission, rejection, editing, and re-submission can take ages to complete and the payments get delayed for the service provided. This can be avoided by ensuring accuracy in filling in information. This can save you from wasting time. Some of the errors which can cause lagging of payments are,
- Incorrect patient’ demographics
- Wrong and outdated patient information
- Duplicate billing
- Unclear or even missing claim number references
- Unattachment of Explanation Of Benefit (EOB)
- Defective documentation and so on.
3. Make sure of no-error coding
Medical codes are standardized five or six-digit codes. The medical coders use these to describe the procedures performed, within the claims. It becomes easier for an error to occur due to its complicated procedure. Such errors include upcoding, under coding, diagnosis codes that aren’t specified, incorrect modifiers, etc.
Some third-party medical billing platforms and clearinghouses can help you overcome this situation by matching all codes on your claims with your actual services for which billing you make.
4. Handling of rejected and denied claims
How you will handle your rejected and declined claims matters the most next. To work on this, first, you have to know the difference between a rejected claim and a denied claim. A rejected claim is the claim that gets rejected due to some errors in the information fed. This prevents insurance companies from making payments. On the other hand, a denied claim is the one that the insurance company denies to pay, due to the findings of any violations of the contract or some other errors. Both are very time-consuming processes to correct.
So it is better to check for errors before submission to save time.
5. Outsourcing technology
Yes! Everyone can do their work by themselves. But if we find any difficulties or if we think about upgrading or making things easily workable for us, there is nothing wrong with getting some professional help. Think for yourself and don’t be adamant about extending your hand for the help you need. There are many software platforms that you can reach to streamline your front desk works. These software use Practice management software (PMS) in collaboration with integrated Electronic medical records (EMR) which can auto-populate your claims with service details that improves your coding.
Come, Let’s join together
Above, we talked about outsourcing technology. Yes, it is very necessary from your side to get professional help to do medical billing and save your time avoiding errors. Vozo is here to help you by providing the software you need the most. We will provide you with the best Medical Billing Software, you can get. Everything, that you need to get your business to the top is available with us. So feel free to contact us.
“Let’s make your medical billing well planned and organized, together”