Medical Billing Practices | emmg

Medical Billing Practices

An important part of revenue management, the process of medical billing is known as the communication between the medical practice and the insurance company, also known as the billing cycle. This cycle can take months if not done properly and can take many back and forth communications if there are problems.

 

If a claim is rejected during the billing process, the practice must review, reconcile, make appropriate corrections and resubmit the claim. This can be a lengthy exchange and may be repeated several times before a claim is accepted and a full reimbursement is received.

Due to the complexity of medical billing, the number of denials and rejections can reach as high as 50%. Another reason for this high-percentage is due to the insurance companies denial of services that are not covered under the policy.

 

Your billing procedures can have a significant impact on the financial health of your practice.

 

Here are a few billing tips to help you receive payments faster and reduce risk to audits.

 

  • Have policies and procedures in place. It is important for the billing staff to have clear guidelines to follow. Some examples are: adjustment and write off rules, appeals process, and patient collections. Having clear expectation for the billing staff will improve accounts receivable management and ensure compliance.

  • Make the best use of all the tools of your billing system. Tools like insurance verification, claims status, electronic remittance, and many more are available to practices. These tools can expedite claims, processing, and collections and increase your efficiency.

  • Establish benchmarks and analyze the progress. Identify a benchmark of where you are and analyze your progress over time. This allows the billing staff the ability to identify and correct areas of weakness in the billing process.

  • Monitor claim errors and denial rates. Make sure to pay attention to claim denial rates including denial reasons for each billing staff member. This makes it easier to identify recurring denials and prevent them in the future.

 

EMMG offers a comprehensive suite of custom services covering all aspects of billing, collections and revenue cycle management. Because of our vast experience in physician billing and working with practices in virtually all medical specialties, we typically review and evaluate the current list of billable procedures to develop a tailored solution and routinely identify new revenue opportunities.

 

If your practice could benefit from medical billing services, get in touch with our qualified staff here. The team at EMMG will be happy to help!

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