Optimize Medical Billing for Propitious Revenue Management

By Daya Mukherjee Jun 18, 2021
Optimize Medical Billing for Propitious Revenue Management

Obstruction in cash flow can damage the operations of an organization immensely, and when the pattern gets repeated over a period of time, it can cause the organization to incur a heavy loss and financial crisis, no matter what your operational vertical is.

In the healthcare industry, stuck claims, denials, reworks, and write-offs alone cost millions of dollars to organizations every year. The lack of optimized billing and claim execution leads to loss of millions of dollars, which is something that can be avoided with the streamlined processes.

Let’s take a look at a few ways to boost revenue via medical revenue cycle management.

Timely & Effective Communication

A major reason behind the delay in processing claims is due to unclear correspondence.

Billing and collection procedures in the medical practice are tedious, and the correspondence between the payee and the patient can have vital information like official documents that facilitate smooth claim processing. This is one of the factors why outsourcing medical billing trends in the healthcare industry across the globe.

Outsourced resources can efficiently handle the correspondence for the medical claim in a timely fashion; thereby ensuring smooth processing, on-time payment, and fewer denials, reworks, and write-offs.

Contract Application

Underpayment is a big threat to billing optimization in medical organizations and to manage the same, effective contract enforcement is essential.

As per the statistics, about 7 to 11% underpayment is generally common in medical billing. Then there are additional factors like similar service yet difference in the payment received by medical establishments.

In situations like these, managing medical contracts is vital to ensure that the payment received is at par with the services rendered. Medical revenue service collections can be made consistent with the aid of outsourced solutions and resources.

Counter Denials

The whole payment hits a dead end, often when the insurance provider puts a stamp of denial on the request for medical billing.

To facilitate a healthy cash flow, medical practitioners and organizations need to ensure effective denial management. Keeping the denial percentage down by even as much as 97% is an uphill battle. In this case, 100% acceptance is nothing but a dream for businesses in the medical realm.

On the bright side, outsourcing is the perfect answer to this grievance. Numerous businesses and practitioners all across the globe are benefiting by delegating this task to outsourced expertise. Outsourcing service providers that offer denial management in medical billing implement time-tested strategies to not just manage but re-process and reimburse denials.

Cleanse Your Claims

The time and money spent in resubmitting denied claims can be saved if you work towards submitting clean claims at the first attempt.

The parameters and restrictions for submission should be properly taken into consideration while filing claims. This will curb the need for resubmission and will save a good amount of time and money. Despite this being clear as glass, the FPA (First Pass Acceptance) rate lies between just 79-85%.

Clean claims should be a focus for businesses and individuals in the medicine domain. To help achieve the same, outsourcing can certainly prove to be an efficient tool. With the aid of professional assistance, filing clean claims becomes a breeze.

Code Perfect Claims

Accurate coding is necessary for optimizing revenue cycle management, as medical billing and coding requirements are much more closely associated than most professionals realize.

Businesses and practitioners should ensure that the coding requirements are met with diligence in order to reduce claim rejections and cut down the resubmission cost that amounts to $8-10 per claim.

Many businesses hire a medical billing expert from India to meet the coding requirements for precise claim registration and smooth processing. Factors like low cost of living and availability of skilled resources, together make the country a perfect outsourcing destination for processes like medical claim billing.

Outsourcing Medical Billing Services

Sustaining cash flow in any business is rejuvenating and outsourcing is a perfect answer to achieve the same.

Amidst uncertain dynamics of the business realm, outsourcing offers the advantage of consistent revenue generation for small and big medical facilities. Not just this, medical revenue services offer better collections and manage denials in the most effective way.

Let’s take a look at some of the major benefits of outsourcing medical billing services.

  • 1. First of all, you have to admit that hiring full-time resources is a costly affair. The gross income takeaway coupled with resource allotment within your premises, is much higher than the cost of outsourcing.
  • 2. By choosing to outsource, you not only save money but also get real-time data with dependable services. Outsourcing contracts comes with a guarantee of dependability, you can switch to a new service provider, when and if the outsourced resource isn’t meeting your parameters or isn’t operating as per their SLA (service level agreement).
  • 3. Training the resources for medical billing revenue management is another area where outsourcing offers a cost advantage. The trained professionals will efficiently understand your process requirement and will render the results that benefit you.
  • 4. Technology is evolving continuously and even in departments like medical billing, automation has bought about a great change. However, implementation of new-age technology can be costly. With outsourcing, you can reap the advantage of automation sans hassle and expenses. Outsourcing service providers stay updated with the latest technology, thus offering businesses automated and error-free solutions.
  • 5. A new resource will take time to adjust within the eco-system of your organization. However, an outsourced resource, who is continuously working on the same process, will be more efficient.
  • 6. Monitoring metrics is another task that is a part of medical billing revenue management. By outsourcing, you can conveniently depend on your service provider for the same. Outsourced service providers offer quantitative assessment to identify the glitches and smoothen the process.

There are many other benefits of outsourced medical billing and revenue management solutions. However, picking the right service provider is crucial. A thorough market research and referring to the credibility scores of the top service providers are essential, before you pick a revenue management partner.

Medical billing facilities offer stable revenue that is essential to run your business. So, find a medical revenue management service provider judiciously, who holds ample credibility and experience in the domain.

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