Top 7 ways Hospital Billing Companies Can Streamline Profitability in 2021
Recent changes to the United States healthcare industry brought about a variety of new challenges for medical practitioners and also for patients. To keep tight claim processing, hospital billing companies face several challenges.
However, the claims rejection/denial rate touches an alarming level when healthcare practitioners do not optimize their RCM. Each year, due to underpayments, an average healthcare practice loses 11–12 percent of its net revenue. While billing, payments, claim to process, and RCM amounts to 12–13 percent of the total hospital expenditure, which in monetary value equals 2.7 trillion dollars.
There are 2 major cause for a claim not to get paid -
- Incorrect or inadequate claim
- Insurance providers don’t receive the claim
If healthcare practitioners take the right steps and use the appropriate strategies, they can overcome these challenges and make their business gloomy. In this article, I have discussed the top seven ways hospital billing companies can streamline profitability in 2021.
1. Improve Billing Transparency
To get an estimate of the total bill without difficulty, a medical claim should clearly state the codes. Not only healthcare practitioners, even patients, can easily read the claims.
They must have the facility to check the claim is accurate and billed correctly. Ultimately, it results in maximizing transparency in the billing process.
2. Use Advanced Methods
Handling denials, monitoring claims, tracking claims, tax IDs, etc., are a few hectic and challenging tasks. Your medical staff must have hands-on expertise in working with HIPAA regulations.
Thus, to prevent a claim from rejections and denials, your medical billers and coders staff must have automated medical billing tools.
3. Keep an eye on updated regulations
Every year, the American Medical Association updates eliminates, and adds CPT codes and changes guidelines according to the CMS requirement, followed by applying new ICD-10 codes.
Your billing staff should utilize the best resources to make sure that reporting is correct and compliant.
4. Timely Filing
Generally, when filing a claim with a payer, there is a time limit. It may lead to claim denial if medical staff take more time when submitting a claim. Even if the billing staff submits a claim before the deadline, they must be mindful that it will not be accepted right away, leading to a missed revenue opportunity.
So hospital billing companies must file claims on time.
5. Clean Claims
Submitting a clean claim directly relates to how efficiently a healthcare practitioner collects payment from the insurance carrier. In order to optimize and protect timely payments, it is essential that providers increase their clean claims which positively streamlined their practice’s revenue.
6. Minimize Denials
It automatically lowers the denial rate, when the revenue cycle is streamlined and minimizes the errors in the system. Payments of the medical practitioners are denied due to mistakes/errors in the payment claims. When these errors are eliminated, it reduces the denial rate and maximizes the practice’s productivity.
7. Consider Outsourcing
Outsourcing can help hospital billing companies streamline business processes and gain control of revenues. To improve a hospital’s RCM procedures, companies that are experts in revenue cycle management have the expertise and can use their capabilities in data analytics and automation.
No doubt, finding a reliable partner in a variety of industries can bring fresh perspectives to a healthy business.
Key Takeaways:
As the healthcare industry evolves, no doubt maintaining the growth of revenue cycles becomes more challenging. Especially in a tough economic climate, streamlining revenue cycle management procedures is important to boost practice productivity. These 7 strategies guide healthcare practitioners toward more effective methods of collecting revenue and achieve financial practice’s growth in 2021.
Are you looking for a reliable hospital billing company? Then look no further Medcare MSO is here to help you. Our billing experts use reliable resources and provide a clean claim process to streamline your practice’s growth.
