The costs of providing care can simply outstrip the reimbursements. Several factors create headwinds and obstacles that threaten care accessibility and operational stability in physician practices.
With the similar pressures felt globally, providers are feeling a greater need to optimize physician billing operations and revenue cycle management.
The process for doctors to bill includes recording and coding their services. Physician billing and coding professionals manage administrative tasks like procedure coding, insurance verification, claim submission, and so on.
This involves tedious paperwork and numerous requirements that are prone to change.
Hence, to enhance physician billing services you need a team that is specifically designated to accomplish everyday billing tasks and sustain the financial stability of your practice.
Struggles in Physician Billing Revenue Cycle Management
Various internal and external pressures affect the revenue cycle sustainability of your practice. If you are facing any of the following challenges, this is time you rethink your billing strategies.
1) Increasing denials:
Providers across the country are increasingly finding themselves at the mercy of payors seemingly determined to deny claims. The increasingly complex criteria of claim submission are the major contributing factor in claim denials.
2) Staff shortages:
While automation of the billing services is on the rise and helping ease the load of physician billing and coding, physicians also need to rely on RCM specialists considering the changing environment of the healthcare industry. However, providers are finding it difficult to recruit them considering inflation and the competitive market. This has forced a spike in salaries for quality talent, and many practices are relying on less-experienced staff.
3) Regulatory compliance:
Physicians and other healthcare facilities have been facing the impact of the No Surprises Act of 2022. While new regulations are aimed at minimizing unforeseen medical bills for patients, they also resulted in huge numbers of claims being sent for dispute resolution. This indicates that increasing complexities in claim submission requirements are ultimately affecting the bottom line of the practices.
4 Tips to Improve Your Physician Billing Services
Developing a successful physician billing and coding operation is within reach for you considering a few key steps.
1) Collect more information:
Never miss an opportunity to gather information about the patient. Even before the physical appointment, when they first seek care consider collecting comprehensive information about the patient which plays a key role in documentation and billing. Furthermore, collecting information about the patient’s insurance coverage benefits and eligibility, helps you in verification that plays a key role in RCM.
2) Streamline prior authorization:
Employing an automated system for preauthorization along with accurate and comprehensive information collection can ease the pain of tedious paperwork. This increases the efficiency of your process while reducing your administrative burden.
3) Analyze claim denials:
Tracking, monitoring, analyzing, and resolving the claims are essential when it comes to the financial stability of your practice. Identify the patterns and reasons for claim denials to identify the loopholes in your physician billing services. This can help you rectify the overall process and put a halt to revenue losses.
4) Embrace outsourcing:
Amidst the changing healthcare regulations and care protocols, managing a streamlined physician billing and coding process is difficult. Numerous providers are leveraging the benefits of an outsourced RCM specialist organization which has a huge pool of expert medical billers and coders. Along with providing more time for patient care, offshore staff can use their expertise in payment collection and stabilize the overall operations of your practice.
In addition to enabling health services to offer RCM support 24/7, quality outsourcing providers in affordable economies and suitable time zones also guarantee a consistent revenue cycle.
Conclusion
Managing your physician billing service and revenue cycle is essential to continue doing what you always have done. There are numerous ways to improve your practice’s bottom line from investing in technology to partnering with a physician billing company.
Maximize your practice’s financial potential with a strategic approach that holistically improves billing and coding processes and sustains revenue in the long run.
In addition to ensuring that no claims or services remain unbilled, billers working for doctors also keep an eye out for coding and billing problems. Discover how outsourcing can help you enhance your practice’s performance and revenue in the long run.
