Healthcare is going through a period of time where there is no more leeway for billing and claims mistakes. Hospitals and clinics are in a situation where every single penny counts, and long gone are the days when missing out on medical claims leaves no noticeable impact on a practice.
Medical billing mistakes are a common cause for lost profits. Let’s review some of the most common medical billing mistakes, as well as how some hospitals, providers, and clinics are creating a more patient-focused environment in order to improve collections.
Common Medical Billing Mistakes
A recent article published in Healthcare Business Tech illustrated two of the most common medical billing mistakes that contribute to a loss in profits. According to the publication, “it is estimated that doctors in the U.S. leave approximately $125 billion on the table each year due to poor billing practices.” This figure serves as a big reminder that providing quality patient care is only one factor needed for success in the industry, and more attention needs to be paid to medical billing processes.
The following are two common medical billing mistakes according to the Healthcare Business Tech article:
“It is estimated that up to 80% of medical bills contain errors. Insurance companies are very strict on correct medical billing and coding practices, and even the smallest mistake can cause an insurance company to reject a medical billing claim.” When this occurs, there is a long process that ensues in which the doctor, provider, or hospital must fix the error and resubmit the claim and then wait for a period of time to see if it has been accepted and processed. This sometimes lengthy process can result in a waiting period of months before the service provider receives any payment.
Failure to Stay Current on Rules and Regulations
“These rules are constantly changing, requiring physicians and administrators to spend time and money on continuing education, software, or staff training to stay current, having a direct effect on the cash flow and profits of a practice.” In addition to the rules and regulations concerning medical billing constantly changing, the regulations on healthcare in general are also changing, which causes confusion. Proper medical billing processes are more important than ever because the updates and changes to the Health Care Reform Bill have increased the number of Americans with insurance by more than 30 million.
Patient-Centric Billing Improves Collections
Jennifer Andersson, director of admitting and Registration at Chicago’s Northwestern Memorial Health Care, was recently interviewed by Healthcare Finance News where she described how changing the culture of billing and admitting improved collections. Andersson describes that the “secret” to improving the collections and billing process begins with the creation of a new staff culture and mindset that focuses on creating the best possible patient experience.
Andersson described some of the processes she spoke of in more detail at a Revenue Cycle Solutions Summit in Boston. Andersson explained that the addition of new technology that provided a more accurate estimation of patient out-of-pocket expenses contributed to improved collections. Other factors that that helped improve collections included extensive employee training, an improved hiring process, and staff incentives.
Claims Management Solutions
At the SSI Group, we help organizations minimize claims denials and speed up the reimbursement process with advanced technology that promotes successful core practices and helps improve your organization’s rate of clean claims. Fill out our quick form to request a live demo to see how our Claims Management software can help improve your organization’s bottom line.