The fertility billing services involve several clear steps to keep things running smoothly and improve financial performance. Any small mistake in these steps can lead to delayed payments, claim denials, higher costs, fines, or even legal problems. When you’re facing these challenges, outsourcing fertility billing can be the best solution to handle these issues efficiently.
A professional third-party fertility billing company ensures a perfectly streamlined fertility billing solution by implementing the steps mentioned below-
Effective steps for ensuring seamless fertility billing services:
1) Collection of accurate patient data:
This is the first step in the whole process. In this step, you must gather accurate patient information. Getting accurate and complete data here sets the foundation for everything that follows in the fertility billing process. Your front-end team plays a key role in collecting the most up-to-date information, including:
- Name of your patient
- Age of the patient
- Exact address
- Contact number
- The reason behind visit
- Health history information
- Medical diagnoses
- Specific treatment course
- Medical records
- Name of the insurance provider
- Policy details
- Allergy history
You must collect all the information mentioned above to ensure proper treatment, clean claims submission and finally, efficient fertility billing solutions.
2) Systematic insurance verification:
Once you are done with patient-registration, it is time to verify a patient’s insurance information and eligibility before scheduling patient-appointment.This is essential for figuring out what services your patient’s insurance will cover. Since insurance policies vary and can change at any time, regular verification helps ensure that the services you provide are covered. If a patient will need to cover any costs, you should let them know upfront to avoid issues later. You can verify insurance in the following ways:
- By directly contacting your patient’s insurance company over the phone
- Checking information online
You can leverage a streamlined process to reduce manual labor, human error, and claim denials and amplify timely reimbursement for the provided services.
3) Generate accurate bills:
After the patient leaves, you need to gather all updated information, medical reports, and details of the services provided into a single document called the super bill. It includes all the important details, and even a small error or missing information could lead to claim denial.
This particular job should be performed by the team of professional coders in your outsourced fertility billing partner and the bills should include all the information mentioned below-
- Clinical information related to fertility care
- Contact information of the patients
- A patient’s demographic
- Medical history of your patients
- CPT and ICD-10 codes
- Exact date of provided services
- Accurate diagnosis details
Maintaining accuracy in coding is an absolute necessity for you as it ensures maximized reimbursements from insurance companies. Using inaccurate codes can cause your practice to face denied claims, payment delays and revenue leakage. This is exactly where a professional fertility billing company can make the difference as they always recruit certified and experienced coders to handle your billing jobs.
4) Charge entry:
Charge capture is all about carefully documenting every service provided and entering the full healthcare costs into your billing system. Medical billers keep track of all the services and their matching medical codes with the correct charges..
5) Claim submission:
Once you are done with claim compilation and checked for accuracy, it’s time to submit the claim. All the fertility billing claims must be going through two steps-
- Scrubbing: Your claim form is checked by Electronic Health Record (EHR) software, which reviews all the important data. It looks for any coding mistakes or incomplete fields to ensure everything is accurate.
- Leveraging a clearing house: It is a third-party company that works as a bridge between you and insurance companies. They handle reviewing patient records, including current insurance details, name, date of birth, and any coding issues, and then send the information to health insurance companies.
- Patient statement: You need to provide a full record of the procedures and services given to the patient, along with the costs. Include how much the insurance covers and what the patient still needs to pay.
Also, do not forget to include Explanation of Benefits that you receive from an insurance company. This helps show which services are covered and which aren’t, so your patient understands why they still owe you money, even with insurance.
In summary, fertility billing plays a vital role in your practice’s financial growth. Outsourcing fertility billing is not just a choice; it’s essential for handling the challenges of today’s healthcare system. By outsourcing, you can reduce claim denials and substantially boost your revenue cycle.
