The health care billing offices tend to wait until they receive rejections and denials, before resolving claim issues. This is an insufficient process, as it delays the payment cycle reducing the probability of payment. Managing the healthcare billing system is crucial as the providers should give billing staff access to claims management data and establish claims management policies. There is a need to set up policies and procedures to ensure that the team is carefully checking reimbursement requests before sending them to payors. Some path must be followed to track the claim denial rate and set increasingly challenging goals to improve the performance over time.
Strengthen your RCM to prevent common errors
Most of the denials are due to missing information. The providers should pay more attention to collecting the complete and accurate data during the start of the cycle, for example, patient registration and scheduling. This provides the groundwork for which claims can be billed and collected in the most efficient and effective way possible.
Despite contributing to higher claim denial rates, practices check a patient’s eligibility before the first appointment and only one-quarter check during subsequent visits. The front-end RCM and billing staff should be more proactive about verifying patient demographics and insurance information to prevent claim denials. Most claims are denied due to minor errors. Must train your staff and providers who impact the billing system so as to minimize agony at the back end. The best way to avoid this agony is by using an automated system.
Automated System streamlines claim denials management
Implementing more automated claim denials management processes can help providers to navigate different payor rules and codes. The software providers automatically update codes and requirements so keeping up with all diagnostic codes and different insurance policies can be exhausting. Using the software will cut down your research time, allowing your billing team to spend more time making sure that all the requirements are met.
Data analytic tools equally optimize claim denial management strategies. It consists of analytic dashboards, interactive reports, and claims-level data so that providers can easily streamline and correct potential issues before submitting the claims.
Claim Denials should be addressed in a timely manner
When a payor denies a claim, providers risk losing crucial healthcare revenue. Most of the time these claim denials are never resubmitted. Sometimes the billing teams are focused on their daily routine that they overlook these denied claims. To recoup these claims for reimbursement the team must follow a standard procedure where denied claims are reviewed every single day. Just because they are denied once does not mean they will be denied again. The billers should be capable enough to capture the reimbursement with attention and perseverance.
In every practice maximizing reimbursement equals to maximizing revenue. iPatientCare provides effective billing practices and consistent attention to details of the practice. iPatientCare has a well-managed billing team that focuses on increasing practice revenue so that the physicians can give undivided attention to their patients’ health.