{"id":16343,"date":"2011-04-27T10:09:05","date_gmt":"2011-04-27T14:09:05","guid":{"rendered":"http:\/\/www.poweryourpractice.com\/?p=80"},"modified":"2011-04-27T10:09:05","modified_gmt":"2011-04-27T14:09:05","slug":"highly-effective-medical-billing","status":"publish","type":"post","link":"https:\/\/carecloud.com\/continuum\/highly-effective-medical-billing\/","title":{"rendered":"Common Habits of Highly Effective Medical Billing"},"content":{"rendered":"

Let\u2019s face it: The healthcare reimbursement system is brutal.<\/p>\n

Insurance companies and other payers have developed an increasingly complex and often confusing set of rules and processes that lead to more denials, underpayments, and lost or ignored claims.<\/p>\n

It\u2019s becoming harder for doctors to get paid for the work they perform. In fact, most medical practices aren\u2019t currently collecting everything they\u2019ve earned.<\/p>\n

<\/p>\n

Medical Billing by the Numbers<\/strong> (from the Centers for Medicare and Medicaid Services)<\/p>\n

\u2022 70% of claims are paid the first time they\u2019re submitted<\/p>\n

\u2022 30% of claims are either denied (20%) or lost or ignored (10%)<\/p>\n

\u2022 60% of denied, lost or ignored claims will never be resubmitted<\/p>\n

\u2022 18% of claims will never be collected<\/p>\n

Research from the Medical Group Management Association (MGMA) estimates that payers underpay practices in the U.S. by an average of 7% – 11%.<\/p>\n

Add a 7% underpayment to the 18% of claims that aren\u2019t paid at all, and medical practices are failing to collect, on average, at least 25% of the money they\u2019ve earned by treating patients.<\/p>\n

That\u2019s a total of $125 billion left on the table every year by American medical practices.<\/p>\n

How can your practice reclaim those missing funds?<\/p>\n

Do It Right the First Time<\/strong><\/p>\n

When a claim isn\u2019t paid the first time it\u2019s submitted, the likelihood the practice will ever receive money for that work drops significantly. One of the best ways for practices to improve billing efficiency is to catch potential denials before the claims are submitted.<\/p>\n

Software can help practices accomplish that with a robust rules engine that can automatically identify claims that are likely to be denied.<\/p>\n

The top software solutions use an intelligent engine that constantly updates and adapts its rules so practices can stay on top of the latest claim denial trends and continually improve their collection rates.<\/p>\n

Billing software with a proactive rules engine will:<\/p>\n

\u2022 Increase the first pass resolution rate<\/p>\n

\u2022 Improve speed of collections<\/p>\n

\u2022 Decrease work for in-house staff<\/p>\n

Get Paid in Full<\/strong><\/p>\n

Another problem keeping medical practices from collecting the full amount of money they\u2019ve earned is payer underpayments. Practices are reimbursed different amounts for the same procedure due to the individual contracts the doctor has with each payer. It\u2019s almost impossible to manually keep track of every payer contract, so it\u2019s impossible to know when the practice is being underpaid.<\/p>\n

Many practices are turning to software that can automatically compare the actual payments the practice received with the payments specified in each payer contract and send an alert when those numbers don\u2019t match.<\/p>\n

An effective contracts application helps your practice:<\/p>\n

\u2022 Raise net collection rates<\/p>\n

\u2022 Increase efficiency and organization<\/p>\n

\u2022 Forecast future collections<\/p>\n

The Power of Reporting<\/strong><\/p>\n

To make the best decisions it\u2019s important for a medical practice to be able to mine data for billing and collection trends to figure out where the practice can improve.<\/p>\n

The simplest way to do that is with an intuitive software system that allows practices to schedule reports to be created at certain intervals for on-going analysis, as well as generate custom reports on the fly when specific information is needed quickly.<\/p>\n

Analytics can optimize your practice by:<\/p>\n

\u2022 Creating easily understood reports for better decision making<\/p>\n

\u2022 Reducing staff requirements and increasing productivity<\/p>\n

\u2022 Catching mistakes and underpayments<\/p>\n

The increasing complexity of revenue cycle management for medical practices is making it more important than ever to get a handle on the process and efficiently collect more of the money your practice is owed.<\/p>\n

Installing your first practice management system or upgrading to a modern system with the features described above is a major step toward improving your practice\u2019s accounts receivable operations.<\/p>\n

What tips do you have for the tricky task of medical billing? Post below and let us know.<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

Let\u2019s face it: The healthcare reimbursement system is brutal. Insurance companies and other payers have developed an increasingly complex and often confusing set of rules and processes that lead to more denials, underpayments, and lost or ignored claims. It\u2019s becoming harder for doctors to get paid for the work they perform. In fact, most medical […]<\/p>\n","protected":false},"author":1,"featured_media":32788,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[41],"tags":[39],"class_list":["post-16343","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medical-billing","tag-revenue"],"yoast_head":"\nCommon Habits of Highly Effective Medical Billing - Continuum<\/title>\n<meta name=\"description\" content=\"What tips do you have for the tricky task of medical billing? 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