accounts receivable & denial management

 

Medical billing requires several steps, and the claims determine the practice's profitability. Claim denials have become a matter of concern over time and can bring a huge negative impact on efficiency and cash flow. When claims are earned and received on time, profits are all that matter, but if they are denied, they can be a major source of loss.

To avoid the flaws, it is very important to bring efficiency and usefulness in the accounts receivable & denial management process to let the practices survive and work with profits. But this leads us to first understand the flaws and the process of eliminating them. Only the elimination can help in effective management.


1. Communication issues                                                                        

Lack of knowledge is the biggest enemy and brings multiple issues. Irregular follow-ups, multiple calls on the same issue, etc. AR needs deep understanding and solutions that can be:

·         Regular training of the team for deep understanding

·         Assign callers for the individual purpose to avoid any confusion

·         Eliminating gaps in information gathering

·         Analyzing data periodically





2. Loopholes in Call Documentation

What you hear can be different from what you are writing. This is called the gap in call documentation. Even a little difference in the patient information and the insurance details can bring hassles. So, what can be done to overcome this problem?

·         Call recordings are an efficient way

·         Building software to capture the right information

·         Call periodically in a consistent flow

·         Make a flawless documentation


3. Denials bring more internal friction

It becomes very difficult for the team to manage the denied claims and this cause the burden on the employees that start shifting from one to another. Also, the denied claims take double longer time for approval; one piece of information missing can create a problem. So don't forget:

·         Increasing the insurance complexity

·         Off-time claim filing

·         Insurance coverage on time

·         Complex insurance process

Claim Denialmanagement is imperative and this makes us wrap the blog by saying…

Claim denial is a problem and a blunder in practices; the process sometimes becomes so complex with the staff and timings, thus, managing it becomes mandatory for all healthcare facilities. Automating and streamlining the process can bring flawless working. Outsourcing the denial management process can make the task easy and help in reducing the burden on staff. The time and the energy can be saved and reduce the denied claims. Therefore, an effective denial management process is needed.

Comments

Post a Comment

Popular posts from this blog

The growing importance of physician practice management strategies in your practice

Streamlined workflow is not natural. It is earned. With so much happening in all the departments, it becomes important to make the most effective use of time and effort. Streamlining operations is crucial from a patient-experience point of view which must be hassle-free and efficient. Billing is one department whose efficiency makes the most difference in your practice. Outsourcing to Physician Billing services can make things easier and much more efficient for you.   What is physician practice management? It is a management service organization that oversees your non-clinical tasks, including the financial aspects of medical billing, ancillary service department, IT, marketing, and staff management.   Why do you need a physician billing service?   It is difficult for a medical person to ensure the appropriate care to the patient and also perform administrative tasks as well. Frankly, it is a lot to ask for a person with little or no experience in front-des...
Read more

5 Considerations when Selecting Physician Billing Service

Image
Physician Billing Services are different from Medical Billing Services in many ways. They are tailor - made for medical services extended by physicians and healthcare providers to insured patients . The physician billing service s include regulation of administra tive tasks related to medical services provided for the patients like organizing appointments, registration, check in / check out and collection of payments.    To get the reimbursements healthcare practices have to be proficient in the process of billing along with coding. But with the rise of medical billing companies, outsourcing the physician billing process has become more accessible with increased efficiency of the practitioners. If you are a physician looking for billing services, you must choose carefully and keep certain things in mind before finalizing any company. Here are some factors that you should consider when selecting any Physician Billing Services : Things to keep in mind before finalizi...
Read more

3 common Cardiology Billing Challenges

Image
Cardiology in itself is a very complex field. As a cardiologist, there is a need to constantly keep a check on your patients and no mistake can be tolerated in this profession. You have to take your work seriously and efforts should be made to satisfy the patient by taking care of his heart and body in the best possible way. It can get overwhelming for cardiologists when they have to manage different things on their own. All the aspects require equal attention and should be handled well whether they are related to the patients or not.  There is a need to manage your cardiology practice efficiently so that the things don’t get messed up and the focus is not diverted from patients to anywhere else. One big challenge in cardiology is - Medical Billing. It includes collecting and documenting the patient’s medical records. The entire billing process is challenging and involves many steps to be performed. But there are cardiology billing service providers who automate the entire process...
Read more