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How to Reduce the Margin of Error in Your Claim Processing

Billing manager reviewing reports with calculator, papers, and glasses on desk with hands crossed.

Gaps in claims management strategies lead to frustrating denials. In recent years, the margin of error for medical billing has been as high as 70%. No wonder so many patients are challenging their medical bills. They have lost trust in the insurance claims management process. These challenges cost patient trust, delay payments, and require more investment by you and your staff to get paid for the care and treatment you have provided.

What are the best ways to reduce the margin of error in your billing process? Follow these tips to help you master the insurance claims management process and collect accurate and prompt payments.

Go Digital

Reducing paperwork by going digital helps streamline your entire billing process.

Storing patient information electronically ensures nothing slips through the cracks. Patients fill out the initial forms, and their records are stored safely for the long term without concerns of getting lost or damaged.

Staff can stop shuffling paper and be more efficient with their time since they will not be double-checking for clerical errors, mistakes, or missing information. Real-time verification of benefits and patient eligibility improves the accuracy of the services your practice provides and the costs that go with them.

Ensure Proper Coding

Another way electronic storage improves your insurance claims management process is by reducing coding errors. It is crucial to bill accurately for every part of a service. Claims are often delayed or denied due to mistakes in coding, but they can be checked and corrected before submission through the claim scrubbing process.

Use Claim Scrubbing Software

Claim scrubbing is a considerable advantage of electronic claims management. Claim scrubbing software can catch errors that could potentially cause insurance companies to deny payment for the claim. Before submission, it will alert you to the errors that need correcting and provide advice on electronic readmittance. The benefit to your practice is a drastic reduction in rejections. It is crucial to verify the correct code since getting just one digit wrong will cause a claim to be denied. While your staff could complete this task, claim scrubbing software is better and more efficient at catching errors.

Shorten the Billing Cycle

With the proper software, you should also be able to check procedure codes, submit clean claims, avoid costly mistakes, and get paid faster.

Bill the Responsible Party

If a client has more than one insurance provider, you need to understand who to bill first. Verify with each patient to ensure you are billing the correct insurance provider as the primary, secondary, etc.

Send Bills Promptly

If an insurance company has a deadline for submitting claims, you need to know it and send bills on time. Many claims must be submitted within 90 days, and claims can be rejected if the deadline is missed. Ensure your medical billing staff is on top of each deadline.

Use a Clearinghouse

A medical billing clearinghouse will increase your efficiency through the entire insurance claims management process. A clearinghouse is a third-party intermediary who will process electronic claims and complete the claim scrubbing for you. Just by going through a clearinghouse, you can reduce rejections from insurance companies.

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Manage Staff Effectively

Throughout the entire billing process, your staff is the key to effectively communicating with patients and gathering and inputting the correct information, and it begins the moment the patient walks through the door.

Communicate

It begins with effectively communicating with your employees. They handle the processes and live out the policies daily and can provide valuable feedback and ideas on ways to streamline them. Find out from your medical billing staff how errors are occurring and what challenges they most often encounter. Implement ways they can better comprehend the billing process and reduce the number of claim denials you are seeing. Make sure billing policies are clear and that staff is communicating the policies well to your patients.

Increase Patient Understanding

You depend on your staff to make sure patients understand their responsibilities and gather all necessary information. Be very clear about financial responsibility on your patient intake form. Patients need to know that they will be responsible for payment of services, knowing your network status with their insurance, and understanding the differences between various options in insurance plans.

Increase Employee Competency

One small error in the medical billing process can snowball into several more, and the cost to your practice can increase exponentially. Implement any necessary periodical or ongoing training that will improve understanding of coding and software. Create procedures to eliminate ambiguity or confusion in the process. Ensure the system of tracking denied claims works well for you and your staff and improve your follow-up process if necessary. Consult with staff to track claims throughout the entire revenue cycle and shorten it if possible. Investment in employee competency is an investment in the wellbeing and future of your practice.

Know Current Regulations

Regulations are ever-changing, and you and your staff must stay educated on all changes for effective insurance claims management to reduce billing errors. Staying up to date on the latest regulatory standards is an essential factor in eliminating problems in the billing cycle that cost time and money to correct. Use updated technology and software to help you and your staff stay on top of regulations, and make sure your staff training is up to date on any changes that have been implemented.

It’s Time to Get Paid

The insurance claims management process is intricate, but you can simplify it and reduce the billing cycle by going digital and managing staff effectively. Don’t waste any more time on frustrating denials from insurance companies or patients. Schedule a Demo today and find out how you can complete accurate claim processing in minutes. Put the focus back on your patients and trust a clearinghouse to manage the in-between with insurance companies so you can get paid today.

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Apex EDI, Inc.
556 E Technology Ave
Orem, Utah 84097
Support: (800) 840-9152
Sales: (801) 383-0388
Fax #: (801) 642-0333
 
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