How to Track Claims and Denials

One of the most difficult components of running a medical practice is dealing with insurance. Regulations can appear arbitrary because they are so complex, and even straightforward tasks can become time-consuming processes.

Tracking claims and denials is essential for making money. In order to avoid making the same mistakes that led to the first denials, you must follow up on claims.

According to Physician’s Practice, most clinics ignore this since dealing with denials is “more work than someone wants to go through.” But there are methods that can simplify the procedure. Here are four examples of how to do it.

Hire someone who specializes in denials

If you had someone whose main objective was to correct claims that had been denied, it would make tracking claims much simpler. From there, that person might either proceed with the appeal process or receive the money immediately.

Your claims analyzers will work more efficiently if you have one of these people on staff because they won’t have to stop every time a rejection comes their way.

Review accounts receivable

Recognize that you will normally have a 90-day billing window. Due to the generally lengthy response times of insurance providers, you can miss an opportunity to bill if you are not tracking accounts receivable. Any claim that hasn’t been paid after 60 days should be thoroughly investigated to make sure you haven’t missed the window.

Look for patterns of no payment

Codes and claims are handled in various ways by insurance companies. If you can spot trends in their payment, you can drastically cut down on rejections and simplify the tracking process as a whole. For instance, you can ensure that the right diagnosis code is included on claims for that treatment to reduce denials, appeals, and turnaround time if you are aware that a payer only pays for a procedure for certain diseases.

Stay committed to the appeals process

Do you know that more than half of all appealed denials result in payments? Most of the time, a corporation won’t go through the appeals procedure, particularly if the sum is very little. Or they’ll give up after getting one rejection.

The majority of appeals can actually be won if you put in the necessary effort. This could entail third- and fourth-round appeal attempts. The majority of practices will choose to “eat” the costs because they are either unwilling to do this or lack the time.

A medical billing company can be useful in this situation. They will vigorously appeal until you receive payment while fighting for your reimbursements. We at A2Z Precise Medical Billing Services can help you with that.

Top 5 Benefits of Outsourcing A Medical Billing Team

Most healthcare providers want to boost their billing process as it involves various concerns, both in terms of unpaid reimbursements and time spent. Despite the fact that’s complicated, several practices are getting an in-house team for billing. From medical biller recruitment to retention, it’s quite a complex job to stay updated on regulations and manage vacations as well as benefits.

But, keeping dedicated billers doesn’t make sense in most of the practice. And so, the majority of medical practices are currently selecting to outsource a medical billing team for their task.

So, let’s discuss the benefits of outsourcing a medical billing team here –

 

  1. Remain Stress-Free

By hiring healthcare billers from outsourcing, you will get ample opportunities to concentrate on what’s more important and put your remaining work on someone else who is more specialized in billing. So, the billing process, accounts receivable/payable, regulations, and other jobs will no more give your stress and you can offer quality care to all your patients. Outsourcing highly-trained billers to handle the total billing process will also involve no mistakes, and spare yourself the stress of performing your main responsibilities as a professional.

 

  1. Get Instant Money

An essential component of every organization is cash flow. Medical billing businesses are introduced to handle billing faster with minimum errors. You have fewer errors and claims are sent out more quickly when the revenue cycle is performed effectively, which will also enable you to get payment on schedule.

 

  1. Stay Updated About Industry Changes

There are various and rapid changes in the medical industry, which you need to understand as it will impact your approach to medical billing. And so, you need to stay updated with all the rules and regulations as necessary. The ICD-11 transition remains a major problem for those who code and bill. Medical billing businesses further have to ensure your practice stays updated with all the regulatory changes.

 

  1. Get Specialized Medical Billing Help

Hiring dedicated billers are extremely useful to get updated medical billing help from them. Most billing businesses have a sizeable workforce, of which a majority are qualified professionals. A team of highly-trained billers will take care of all your concerns when you outsource medical specialists, and it will also work right if you want to resolve all your existing issues related to medical billing.

 

  1. Helps To Reduce Your Expenses

Medical billing businesses function on an economy of scale, in which costs are spread across multiple customers and individual costs are kept low due to the high production volume. Also, hiring the best billing business will render you the advantages of software, staffing, processes, and partners of trading that are too much expensive when you need to do everything alone.

It helps to reduce your expenses as you don’t require to pay a monthly salary to your in-house billing team. The process of revenue cycle management is quite time-consuming and complicated, which needs the utmost attention to detail. Hiring the best billing business is also suggestive if you want to eliminate errors in medical billings.

This denotes, trust is a major consideration when choosing a medical billing business. A2Z Precise Medical Billing has built that trust amongst providers, after listening to all of their problems we will work accordingly to offer exact reporting as required. We’ll further help to increase revenue and reduce the costs of their medical billings.

So, if you want to consider outsourcing some or all of your revenue cycle management, you can simply enquire us at 734-748-2292 today!

What Makes A Great Medical Biller?

Finding an experienced medical biller is quite a challenging job. For doctors, you are aware of the importance of getting a qualified medical biller to your cash flow. They are extremely important for the business. If you’re fortunate enough, you may have a medical biller who has worked with you for many years and is familiar with your practice as well as testing procedures. So, the two of you can easily communicate with each other.

 

In case you are just starting your practice as a physician, it’s always not possible to afford an experienced medical biller. But, for anaesthesiologists and surgeons, you do need to maintain an in-house biller for the task. In this situation, you need to divide the billing duties between existing employees, which eventually saves the cost in your practice. And so, selecting a good medical biller has lots of difficulties.

 

Now, let’s discuss how to find a good medical biller who can perform your job efficiently –

 

  • Timely Filing

You have limited time to file the claims with an insurance company, and after it exceeds, you just can claim anything. So, looking for a good medical biller helps to have detailed records of where and went to send your papers. In case you’re applying is proven accurate, an insurance company can’t reject to pay off your money. Most billers do this using a clearinghouse, which confirms exactness most efficiently. Also, if a claim is rejected due to billing blunders/ late filing, a medical billing company will guarantee to pay off all claims themselves.

 

  • Keeps Monitoring Rejected Claims

In most cases, insurance companies often reject claims of medical billing. This happens due to a lack of follow-ups. But, if you select a good medical biller, all your claims will remain monitored until they’re accepted by the insurance companies. Hence, it’s always a good idea to select a professional with years of experience in medical billing.

 

  • Maintains Steady Contact With Providers 

While logging and creating a medical bill, providers and billing companies should work together seamlessly to get the work completed on-time. Regardless of having the latest billing software in action, yet a medical billing company still needs to verify and maintain it on a daily basis. It’s further important for billing companies to have top-notch data security, information-sharing rules, recovery methods, and data backup when it comes to using electronic record-keeping to avoid data breaches. In order to maintain regular contact with providers, a medical biller should always stay active to support the doctor.

 

  • Updated About The Latest Industry Developments

A good medical biller needs to renew their certification each year, which indicates the rapid changing of regulations in the medical industry. The dedication required to stay updated with the ever-changing rules is itself a complex job as a medical biller. For those who want to become skilled medical billers, you need to do a lot of hard work for that.

 

  • Knowledgeable About The Medical Industry

A highly-skilled medical biller should have technical expertise as well as a background in medicine. That’s beneficial while submitting claims as the biller will have a good understanding of what things are covered. It further includes acquaintance with particular specialties in addition to years of experience in the medical industry. So, finding a medical biller who is familiar with your area of expertise is quite beneficial. You also need to look for businesses or a person with extensive coding expertise.

It’s nearly impossible to explain someone something from the beginning. For someone with no prior education, medical coding is a completely new language to learn. To trust someone without any prior expertise in coding would be too expensive in terms of time as well as money.

 

Final Thoughts

Having trust in your medical billing company is extremely important as they’ll take the required steps to ensure you are paid for what you do. You also need to get assurance of all the work is completed accurately and efficiently, which intends to save lives. One of the most significant connections in managing your practice as a medical biller is that you should not take any decision lightly.

If you want to explore more about our medical billing solutions, you need to dial A2Z Precise Medical Billing at 734-748-2292 today for the best help!