There are two things that keep your practice open—seeing patients and getting paid. And, the truth is that getting paid has many challenges. Improving reimbursement was named the top challenge by nearly 20% of independent practice owners. From gathering the right information at scheduling to accurately coding the visit to tracking the claim, there are a lot of place where things can go wrong. Add to that the constant industry changes like ICD-10 and it can get pretty overwhelming. The more you automate and use best practices for medical billing, the better chance you have of getting paid quickly and correctly.
Eighty-nine percent of physician practices agree that their billing and collections systems and processes need upgrading. The first step is to find a solution that can automate billing from end to end, eliminating as many places where errors occur as possible. Make sure to:
- Automate eligibility verification
- Use an EHR or electronic charge capture to submit an electronic superbill directly to your biller
- Scrub 100% of claims from submission to payment.
Capturing charges electronically and submitting claims the day the superbill is received reduces coding errors, prevents over and under coding, improves accuracy, and decreases data entry for the billing staff. Your goal should be to get claims submitted in three days or less from the time of service and track them through payment.
Using billing tasks and features like no-response claim tracking can help ensure that no claim goes unpaid or underpaid. To ensure accurate payments, keep fee schedules up-to -date and use electronic remittance advice to post payments electronically. Underpayments result in a 7% loss of net revenue for the average practice, but it doesn’t have to happen in your practice. When all of your billing practices are automated and in order, you should be able to achieve average days in A/R of 40 days or less and have a net collection rate of 96%.
Managing billing and accounts receivable is one of the most labor-intensive tasks in any medical practice. For smaller practices, the staff is often forced to multi-task, providing patient care and follow-up, handling eligibility verification, and taking care of billing.
If managing all this in-house has become too much of a burden, then consider outsourcing. A good billing service can provide skilled, highly trained billers who know your specialty and all the best practices to get you paid.
Upgrading to a single source vendor can offer many benefits to independent practices. A seamlessly integrated RCM, PM, EHR solution has a short learning curve for the staff. Making this move can help reduce errors, eliminate tedious office tasks, improve billing, and get you paid. In fact, a survey by the research group Black Book confirms that 90% of practice managers believe that an innovative, seamless RCM/PM/EHR system would ensure long-term practice independence, and greatly improve productivity and profitability.
For more tips to independent practice success, download 8 Ways to Keep Your Name on the Door.