Medical Billing and Coding

1. Medical Practice Tips to Manage Revenue Cycle The ever changing policies and reforms in today’s healthcare scenario are forcing medical practices to change the way they cycle. Revenue cycle management is all about generating the maximum amount of net revenue. With the recent 5010 transition & ICD-10 switch, growing patient responsibility for payments & declining Medicare reimbursements, healthcare providers are facing a big challenge about getting paid for their services and care. Issues of claims denial, coding compliances, automation hiccups, and staff shortage are all adding to the healthcare provider’s woes. Clinicians need to establish systems, manage their revenue coupled with the right strategies and approaches, to ensure that they are managing their revenue cycle efficiently. Take a look at some of these tips to help maximize your revenue cycle, receive timely and accurate reimbursements, efficiently scrub claims and increase your net revenue. Revenue Cycle Compliance Recent changes in coding, documenting and billing has made it even more imperative that physicians pay attention to revenue cycle compliance and make the necessary changes required for the same. Just because something was done in a certain way till date, does not mean that the change is bad or can be ignored. It is important to ensure that your practitioners are working accordingly and there is an understanding and clarity between your revenue team and your billing professionals. The government with its new norms is examining the issues of billing and payments and it makes sense to ensure that your medical coding, documentation and billing are accurate. Move out of Maintenance Mode Status quo is a comfortable position to be in for most people. However, it is time to move beyond the concept of maintaining your revenue cycle to making it more effective and profitable. It is important to let your team know and understand how to get more efficient by reducing cycle time and billing errors. Improving the current levels of performance and cutting costs will result in maximizing your net profit. Put checks in place to reduce denials, underpayments and bad debts. Ensure that follow ups are regular and analyze unpaid bills – there may be a pattern to the bad debts.

2. Use Technology to Reduce Errors Memory based tasks can lead to errors, proving costly to the healthcare facility. Automation of the accounts receivable system eliminates memory or human error. Technology in healthcare has taken rapid strides in the last few years. Providers who have integrated revenue cycle management technology have significantly improved their ability to collect higher number of payments and in a timely manner. Medical Practices that have successfully adopted technology in their revenue cycle management systems have outperformed their peers from a cost and revenue perspective. Successful technology adapters also find it easier to collect outstanding receivables. Regular Staff Training is a Must The constantly evolving healthcare landscape makes it imperative that your staff is trained regularly to ensure that they are in tune with the latest changes. It is also of paramount importance that the expertise level of a staff or physician aligns with your revenue cycle goals. Healthcare providers are reimbursed on a transactional basis. Their expertise is in patient care and not proper medical coding, medical billing or patient collections. However, it is important that they understand and focus on Meaningful Use, EHR adoption, PQRS, ICD-10 codeassist services, etc from both the clinical and regulatory perspective. Training and educating your staff and clinicians on the different aspects of the revenue cycle will definitely prove beneficial financially. Cross training your best staff members is also a good option, as this creates members who can do multiple tasks in an emergency.