Has your practice seen an increase in patient phone calls surrounding billing complaints? Mistakes on medical bills are not uncommon. In fact, over 80% of medical bills contain errors, whether from erroneous charges, double billings or, in some cases, abusive charging practices. Your practice can avoid these mistakes by following a few simple guidelines.
Medical billing complaints are increasing for several reasons. Now that physicians and hospitals are using EMR systems, more errors are being made. This isn't to say the EMR is to blame for every error, but an EMR that isn't user friendly or a physician that isn't well trained on how to use the EMR can lead to a number of errors in little time.
Some hospitals and physicians are attempting to increase their profitability by using more creative billing code practices. Whatever the reasons for the mistakes on the bills, patients are paying far more than they owe in most cases.
Even consumers with great health insurance plans are paying a greater percentage of their healthcare costs, and many newly insured patients have high-deductible plans that lead to high out-of-pocket costs. The result is that more consumers are examining medical bills more closely, and when they find mistakes, they are bringing them up with providers and insurers to try and get relief. There are a number of ways you can mitigate the effects of disputed bills and their effects on practice revenues and cash flow.
1) Preventing Errors
Preventing mistakes on medical bills requires attention to detail from the time the patient arrives for check-in to the time that the patient checks out. Updating insurance information at every visit is important, as is learning whether the insurer requires extra steps like pre-certification.
Having great medical coders is also a good way to prevent mistakes. Coders should always be updating their knowledge with constant training and staying up-to-date with any coding changes that take place. Periodic coding audits can also help you determine where there is opportunity for improvement and will reveal whether any variation from national averages is due to inappropriate coding or atypical levels of intensity among your patients.
2) Good Communication With Payers Is Essential
When your medical billing staff has good communication with the third party payers you work with, errors are less likely to happen, and more likely to be worked out to everyone's satisfaction when/if they do occur. Some payers provide software that helps medical practices understand what is and is not covered and estimate patient out-of-pocket costs with better accuracy.
If you're able to tell patients up front about how much they will have to pay out of pocket, they're less likely to experience "sticker shock" when they receive their bill. Helping patients understand the costs before the visit takes place will prepare them to pay out of pocket and also allow you to set up a Credit Card on File Program to ensure payment is made.
3) Utilize Your Billing Software to the Fullest
Expecting an easy process with great results for your revenue cycle management without a great practice management system just isn't realistic. A poor practice management system will cause your staff to hate using it and in turn their performance will suffer. And if the practice management system isn't integrated with your EMR you can have some serious data entry and accuracy issues. The right software will not only help you create more accurate bills in a more timely fashion, it can also help you develop more efficient workflows that can tighten the revenue cycle operations.
Some software features to look for include:
• Insurance verification
• Electronic claims submission
• Fee schedule review
• Patient statement generation
• Payment posting
• Easy reporting and financial review
How to know if you should outsource your medical billing
Whether you should outsource part or all of your medical billing services depends on many factors. For some practices, better software and improved workflows can make for a better billing experience and fewer confused or unhappy patients. Other practices may find that outsourcing medical billing services results in more satisfied patients, better cash flow, and more efficient use of practice resources.
Accurate and timely medical billing services and statements are essential to the success of your practice. Patients who don't get their billing questions answered to their satisfaction will switch providers, not pay, or both. Enlisting the help of a medical billing service to assess your operations and workflows can help you make the right decision as far as outsourcing medical billing services or keeping them in-house.
With patients paying for more services out of pocket, they're demanding more answers when they don't understand their bills. While preventing mistakes is ideal, having a team of experts to handle patient questions and address any changes that need to take place in the billing process can help your practice increase revenue and maintain great patient relationships.
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