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Consequences Of Incorrect Medical Coding And Billing
August 17, 2022
Accounts receivable issues prominently threaten the revenue cycle efficiency of every healthcare provider. Recurring serious payment problems trouble the billing team and put a damper on the organization's earnings. The post-service payment model challenges the medical coding team to be on its toes to receive payments. However, there are ways to omit these issues and increase revenue cycle efficiency.
48 percent of healthcare leaders suggest that claims payment is their biggest revenue cycle challenge. Other top three concerns organizations mention included claims denial, prior authorization issues, and staffing troubles.
We address major concerns in the industry and help you increase healthcare revenue cycle efficiency levels.
Related Service: Medical coding services
Industry leaders suggest a data-driven approach to address revenue cycle inefficiencies. Using valuable data, administrators can understand if their staff is following best practices that’ll ensure faster and more accurate reimbursement. Through clinical and financial information, firms can also create and track key metrics as performance indicators. These indicators set a standard and allow easy comparison of work.
Metrics make it easier to measure work and detect inefficiencies in the process effectively. In case these metrics indicate a negative trend, managers can adapt, improvise, and bring the team on track faster. You can track basic indicators like: -
In 2015, approximately three-fourth of healthcare organizations notices a sudden rise in patient financial responsibility due to the prevalence of high deductible plans. Despite the rise in healthcare costs, nearly 70 percent of patients with bills worth less than or equal to $500 didn’t fully pay their dues in 2016. Getting paid less and late puts healthcare revenue cycles at risk or not receiving the full payment.
Providers also bare the costs of deploying help to collect these payments. Through point-of-service (POS) or pre-service payment options, managers can optimize their cycles efficiently. Healthcare providers can also implement the credit-card-on-file facility to boost POS collections. Currently, just 20 percent of organizations offer this option despite knowing that it’s the best payment collection method.
Through this strategy, you can save up to 28 percent of your revenue collection time within six months.
Many healthcare providers are improving their authorization and eligibility requirements to lessen their unnecessary costs. Nearly 86 percent of medical practice leaders state that they’ve increased authorization checks before service. Health plans need prior approval for a physician to order medical tests, execute clinical procedures, prescribe medications, and use medical devices.
These approvals end up wasting a lot of the physician’s time and drive the admin costs up significantly. Additionally, administrative costs increase even more if the healthcare provider still uses manual verification processes. Providers can save up to $5.61 per transaction by opting for electronic prior authorizations.
Revenue cycle managers can efficiently streamline their processes through automation tools and reduce time wastage on repetitive processes which shall increase revenue cycle efficiency by manifolds.
Your revenue cycles depend heavily on your frontend and backend reps. These reps are naturally competitive and respond well to encouragement. Through attractive incentives, you can motivate your top performers to hit realistic targets. You could also lay out graphics to convey which employees are outperforming their peers. With the perfect combination of technology and strategy, providers can set themselves up for success in the revenue cycle management process.
Did you know that nearly 90 percent of claims denials can be prevented? Still, most providers aren’t taking steps to prevent these issues and addressing other backend challenges. In 2017, healthcare providers declared 90 percent claim denials not collectable as compared to the same figure six years ago. This uncollectable revenue amounted to a whopping $3.5 million loss in 4 years for a 350-bed capacity hospital.
By enhancing frontend operations, providers can avoid committing common errors such as entering incomplete data and using incorrect information. Through automation, your staff can take their focus off from non-clinical administrative tasks and treat patients instead.
46 percent of younger patients would pay for their services at the POS if they received an estimate. Most US patients want their healthcare systems to provide a service list with prices on it to assess costs and decide which service they’ll opt. With the rise in patient financial responsibility, providers must ensure they’re transparent with their costs. If patients will pay, naturally transparency will help organizations get paid easily.
You can ease the complete customer experience by providing estimates before service, offering helpful payment options, and using automated billing tools. A recent study states that most patients desire electronic billing and payment collection systems. 86 percent of patients that received cost estimates stated that they understood their financial obligations and this is one of the important strategies to increase Healthcare Revenue Cycle Productivity.
The DOS solution enables data mining, uncovers obstacles, and determines ways to improve healthcare systems. With a good analyst, you can examine data and uncover important insights that can power changes in revenue cycle management. However, they need to be receptive to all feedback they receive and ditch the blame-game. Focus on fixing those issues by finding the best way to handle them and executing them.
In a typical revenue cycle, many things can go wrong. So, revenue cycle managers must ensure a seamless transition between front-end and back-end teams. Through supporting technology, healthcare systems can streamline their hand-offs and focus on improving critical metrics. 52 percent of hospitals use 3+ connected health technologies. Managing revenue cycles is a dynamic and spontaneous process. Optimizing processes and automating them is an effective strategy that we believe every provider must adopt.
These are the strategies to increase Healthcare Revenue Cycle Productivity.
Systematized revenue cycle management is the key to smooth administration for hospitals and other medical institutions. Invensis Technologies, a leading Healthcare BPO Services company, delivers comprehensive Healthcare and Medical Revenue Cycle Management Outsourcing Services. Our services range from pre-registration and scheduling of appointments to coding and billing.
We have achieved HIPAA compliance and are ISO 27001 and ISO 9001 certified. In adherence with these standards, we offer a systematic approach which ensures the safety of patient information and maximizes the efficiency of our clients' operations.
A unorganized system for revenue management can have many adverse effects and negatively impact many aspects of your organization. Invensis has considerable expertise in delivering outsourced revenue cycle management in healthcare and guarantees quick reimbursement and smoother administrative processes as a guaranteed outcome.
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