How to Catch Revenue Leaking in Medical Billing?

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Posted on: January 19, 2023

Medical billing is a huge industry and the revenue cycle plays an important role in it. There are many aspects that have to be taken care of during this stage such as patient insurance and benefits verification, insurance prior authorizations, patient registration, medical coding, charges, claims filing, payment posting and generating reports.

10 Things to Implement to Reduce Revenue Leakage in Your Practice

Right Medical Billing is here to help you reduce revenue leakage, generate leads and increase your client retention! With the suggestions below, you will be able to work on a tight schedule, with less stress and more money in your pocket.

1. Avoid Credentialing Related Denials

If your practices are unable to participate in specific health plans, denials will increase. Your professional team should identify and renew your provider’s credentials requirements and reduce denials. Outsourcing provider credentialing to the credentialing company can significantly reduce denials

2. Un-Billed Procedures

A physician should be aware of procedures that are verifiable to prevent unrecorded procedures. This will ensure that the revenue generated is accurate and reduces revenue leakage by identifying unauthorized services. When having a conversation with your provider, you can ask questions to reveal potential accounting issues related to unrecorded procedures

3. Un Billed Claims

An un-billed claim is the result of loss of more revenue than any other cause. When you link reports of patient’s appointments, procedures performed and claims submitted it will be easy to recognize which ones are referred to as un-billed claims.

4. Managing Patient Balances

I will develop a patient balance management process that will include timely patient recall/texts, electronic payment methods, and flexible payment plans. It will ensure a maximum refund.

5. Underpayments

The volume of services required by most patients is often based on their insurance deductible. One of the highest revenue sources is to know the exact cost of your services. Within different insurance companies, deductions can be avoided by planning and revising your fee schedule promptly. Ask expert support in setting up your timetables.”

6. Fee schedule problems

It is important to talk with your doctor regularly to make sure that you’re paying the right amount. Fee schedule issues can be addressed every month by updating your timetable. Your practice can identify those areas where you are paid less. For example, if there is a high volume of patients at the same time of day, it might make sense to send them out of the office early one day and then send them in at a different time the next day. For a process, fix your fee schedule 2 to 3 times the Medicare’s applicable charges.

7. Inefficient Claim Denial Management

Denial management is a critical step in the RCM direction and requires the highest levels of expertise. Hire a professional team that can submit negated claims again, understand why refusals occur and create an iterative procedure to avoid future denials because of the same problems. Our denial management services will meet your organization’s RCM needs for streamlined processes for terminating bad claims by collecting evidence and gathering accurate information to provide reliable information quickly.

8. Personnel Issues

The inefficiencies or unsuitable training of reception desks and billing departments are causing personnel problems. Train your front desk staff to collect data accurately while taking care of patient’s empathy with this comprehensive set. With our system you will get trained professionals who can submit bills and follow up immediately with your billing process!

9. Unleash The Power of Analytics

Today, most software for the revenue cycle offers several features that help you with your reporting needs. Use these features to produce prompt reports on your practice’s operational and financial performance. Take necessary decisions while taking the main lessons learned from root cause analysis data

10. Patient Centricity

As a healthcare organization, patient care and satisfaction are your primary responsibility. Create clarity about patient responsibility, establish flexible payment procedures, and create a customer service team to keep consistent patient contact. Utilize existing processes to increase communications between you and your patient.

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