Anticipated reimbursement is achievable only if the medical billing process is organized and smooth. Simple and tiny mistakes cost a lot. Disrupted medical billing can bring down the cash flow.
The billing process starts right from submitting the claims as soon as possible. This very step goes haywire in many cases.
To ensure billing is successful and claims are paid faster, 5 mistakes are to be avoided.
1. No following up on claims
When reports age on the table, one really loses track of things. At times, the claims might be on the table just because it has not been forwarded to the payer.
When the claims keep lingering, make an effort to send to the payer and enquire why the reimbursement cannot happen over it.
Not coping with the pending issues and not sorting it out on time is an example of careless service in spite of being rendering claims carefully goes unpaid.
The simple way to sort this out is to be organized. Timely filing is of the essence if you want reimbursement on time.
2. Don’t stick to the Reports
If you take a long time to resolve the issue on the clearinghouse report, it wouldn’t do it by itself. So, though it might take quite some time, you need to read the reports, go through them and come up with the right solution.
At times, the clearinghouse report can say the service done need not require ER. Ensure the ER records are sent along with the claim to avoid adjudication.
3. Lack of Plan
If you haven’t devised a system or plan for filing claims, then it might end up in chaos. 30 days is the timely filing limit with most of the payers.
If you are missing the deadline, the simple reason is enough for the denial. Imagine, there are coding errors and records needed for the claim to be processed.
In such cases, you would be filing the claim again and again for various reasons, and one of the simplest yet crucial thing you can avoid is by filing on time. Create a schedule to stay alert on the time limit.
4. Failing to understand EOB
Explanation of benefits clearly states why the part of the claim is paid, or why it isn’t paid. When it is an underpayment, it is essential to have a look at the EOB and understand if you really deserve the underpayment. It is also crucial to thoroughly check the EOB to resubmit the claim.
At times, specialist’s codes are not paid differently, and only through the EOB, you would be able to find this. Failing to go through it can be a loss.
5. No assigned medical billing officer
If multitasking can go wrong somewhere, it is in the case of a medical billing officer acting as front office executive, personal assistant or whatnot.
Understanding medical billing is the key to cash flow itself would stop this practice of burdening the medical billing staff with other work.
Ensure the staff handling medical billing is not overwhelmed with responsibilities, and have a clear set of tasks that can be assigned to one.
A trained team can only ensure these mistakes are avoided. Another simple yet efficacious way is to hire the services of the third party medical billing company.