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Medical Claims Processing: How the Right Medical Claims Processing Increases Profit

These days, more and more people seem to be noticing – and questioning – their doctor’s medical claims processing methods. But figuring out how your practice can cut down on medical billing errors is only a part of the process.  

When determining how to streamline the business side of your practice there is a lot to think about.

In this post, we’re going to clearly outline how the right medical claims processing can increase your bottom line.

It can even prevent your patients from challenging your medical bill.  

1. Make Sure You Know Each Insurance Policy’s Details

Your medical claims processing requirements will depend on the type of policy and the actual insurance companies of your patients. 

How are you bill these companies for reimbursement? Is it for operating costs, the expense of medical devices, or anything else?

All this, you know, depends on the claims submission process of the company. 

If you submit your claim incorrectly, you’re subject to slow repayment times. Sometimes, this means no payment at all. This leads to a lengthy appeal and resubmission process. 

To prevent this, we recommend researching individual policies prior to making a claim. You may even want to consider hiring someone to complete this process for you. The process can take around 6 hours every week to conduct the proper research. 

Additionally, look into webinars offered by Medicare and other policies to help keep you up to date. Always keep your finger on the pulse of policy changes. Even consider hiring a third party provider to help ensure you’re up to speed. 

2. Use Medical Claims Processing Software/Services To Improve Workflow

In a medical practice, the number of patients you’re able to see every day is directly tied to your profits. 

Using a medical claims processing service means your staff will be able to interact more with your patients. You’ll also get things done right the first time. Now, use office hours to focus on customer and patient satisfaction instead of filing claims and fixing problems. 

Especially in smaller practices, your staff is likely doing more than one job at once. Not only does this mean they’re more likely to make mistakes, it also leads to employee dissatisfaction. That can mean a high employee turnover rate. 

Getting the right claims services can help to make sure your employees are able to focus on the day-to-day operations of your actual practice, not the behind-the-scenes billing and filing work. 

This leaves both your patients and your staff satisfied.

3. The Right Claims System Cuts Down On Resubmitted Claims

It’s common sense. The fewer mistakes you make, the fewer resubmitted claims you have to file. That means you’ll be reimbursed and paid sooner. 

Look for professional billing and claims services that rely on experienced employees that focus only on the tasks of filing and fulfilling claims. You don’t always have the time or the resources to constantly train your own staff and keep up to date with the continuous policy changes. 

But a professional billing service will be up to date . That’s because that’s all they do. Look for services that also have 24-hour help lines or customer service representatives. Other DIY knowledge like forums and online resources where your employees can get basic questions answered the moment they arise. 

4. Look For An Analysis Of Your Claims Management

You’re always looking for ways you can save on time and costs in your practice, right? A good medical billing service can help. It can introduce you to options you weren’t even aware existed. 

They’ll scrutinize your current billing system and offer you ideas about how to improve your billin. They’ll also cut down on the mistakes you’re making.

Especially if you’re a newer practice, we know you’re eager to get things started off on the right foot. You might be concerned you don’t yet have the resources to do so. 

A good medical claims processing system and service acts as a cost-effective preventative measure that will help you ensure your business is streamlined. it will also keep it secure, and up to speed with current regulations. 

They’ll also help you to establish a plan for the growth of your practice, and make adjustments to your billing and claims processes as you expand. This way, you can spend your time focusing on how you plan to build your practice. 

5. Check That Your Billing Codes Are In Order

You likely already know that for every medical service or procedure you perform, there is a separate billing code. At least, there should be. 

Often, when practices are pushed for time or simply don’t understand the claims process, they’ll make the costly and careless mistake of assigning one billing code for an entire procedure. This can happen even if multiple, individually-coded operations or services were provided. 

This isn’t something your practice can afford to continue. It doesn’t matter what phase of business you’re in currently. 

And it’s not just the basic billing codes you need to make sure are correct. Each procedure also carries with it a 2-digit modifying code. For example, indicating which side of the body the operation was performed on.

If these aren’t included, you’re simply not providing the proper documentation to the provider. You’re likely going to miss opportunities for reimbursement. 

If this sounds like a lot to handle, it’s because it is. So why are you leaving it up to your already overworked staff? 

Instead, look into working with a medical claims processing service or software provider. They can make sure that you’ve submitted the correct claims to insurance companies – every time. 

Don’t Make One More Costly Mistake In Your Practice

By now, you can clearly see all the ways that the right medical claims software and practice can save you money, time, and even stress. 

There is no reason to continue losing money when the solution is so clear, and so available to you no matter the size or specialization of your practice. 

Want to leans more about where to find the best claim services, make sure you’re up to date with current policy changes, or to simply have specific questions answered? Spend some time on our website to learn about your options. 

Feel free to contact us to learn more about how we can help both your practice and your patients. 

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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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