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Medical Claims Processing: 5 Tricks to Easily Streamline Medical Claims Billing

Is the medical claims billing process a painful one for your practice? It doesn’t have to be.

Taking a few simple steps to simplify medical claims billing can drastically improve your collections and even increase your practice revenue.

If you’re ready to make this process easier, check out the following 5 tricks below!

5 Tips to Streamline Medical Claims Billing

1. Take Inventory

First, take an inventory of where you are. This way, you can establish goals for, and periodically analyze, the progress and status of your accounts.

You’ll want to do a periodically analyze the progress and status of your accounts monthly or quarterly. Do this by tracking the following:

  1. Number of days in Accounts Receivable
  2. Percentage of net collections
  3. Aging of Accounts Receivable

With an idea of these stats in mind, you can then keep your eye out for ways to improve efficiency. This will then lead to increased and more timely collections.

2. Take Advantage of All Your Resources

There are plenty of resources and tools available to help you with your medical claims billing, so take advantage of them.

Give online tools, programs, and billing software a try. These can make a vast improvement in how effective you can bill. 

Instead of reinventing the wheel, make things easier for yourself and rely on these resources, which will have enough information to make your billing simpler.

An example of some awesome technology you can take advantage of as it relates to the collection process is an automated revenue management tool. Advantages of this tool include:

  • Automated payment reminder messages with convenient mobile or online payment options
  • Reduced amount of time you spend on sending out statements, trying to collect payments manually from patients, and also decreased billing costs
  • Integrated reports that will tell you how much revenue you are waiting on, and even how much revenue you have claimed. 

If you are struggling, however, experts are also available to help.

Medical billing companies can assist you by taking on the whole billing process for you. It doesn’t get much easier than that!

Also available are medical marketing companies, which can help you grow your practice. 

3. Use a Patient Portal

Have you implemented a patient portal into your practice management? If not, you’re missing out.

Using a patient portal can be a huge convenience to not only your practice but also your patients. Offering access to a patient portal will encourage your patients to take a more active role in their healthcare.

Benefits of using a patient portal could include the following:

  • Patients have the ability to view their complete account activity and submit payment information–all with the same security as online banking.
  • Your patients will have access to important documents. These documents could include digital x-rays or before-and-after shots, admittance forms, insurance documents, post-op care instructions, and any other documents you would like them to be able to view. 
  • By sending or receiving secure messages that can be archived to give you an added level of liability protection should the need arise, patients have the ability to communicate easily and efficiently with your practice. 

5. Create Policies and Procedures

Not only should you create policies and procedures for medical claims billing, but you should ensure that everyone on your team is aware of and familiar with them. 

To ensure a more cohesive understanding of expectations, discuss the guidelines and protocol regarding the process of collections with your team. Also, provide a manual for each staff member to use for quick reference. 

This will make it more likely that you will see an improvement in your revenue management over time. 

5. Be Informed 

Having an understanding of insurance coverage will help make medical claims billing easier.

Often, billers don’t know what is covered and what is not. This makes medical billing all the more difficult.

Understanding coverage will give you the ability to know how to bill for services better. Being informed about coverage will also allow you to understand who will be responsible–the insurance or the patient.

Checking eligibility may seem like a daunting task at first. However, understanding what’s covered and what isn’t covered is necessary for proper claim submission, as well as follow-up and patient billing. 

At the end of the day, being informed about and familiar with the different insurance companies your working with (including coverage policies, filing limits, coding edits, global policies, etc.) will make the medical claims billing process much less painful

Quick Tip: You should also keep a record of denial stats. This includes rates and reasons for denial and recurring denied claims in order to spot and prevent them in the future. 

Other Quick Tricks to Improve Your Medical Billing Collections This Year

  • Train staff to collect: Since collections begin at your front desk staff, it’s imperative that they are trained to get the cash before the patient is seen. 
  • Be transparent about pricing: Don’t leave your patients completely blindsided by costs that they have not budgeted for. This is one of the main reasons providers have a hard time with their medical billing collections, so to avoid this, be transparent about the expense.
  • Offer different payment options: Consider offering various payment options to patients who have to pay larger medical bills that they aren’t able to pay in full all at once.
  • Make paying easy: If you want your patients to pay their bills, you need to make the process as easy as possible. Online bill pay can be a huge help with this.
  • Incentivize your billing staff: First, you should recognize that it’s not a ton of fun for your billing staff to call patients day in and day out asking for collections on past-due accounts. Since this process can be frustrating and tiring, potentially leaving staff unmotivated, always show appreciation and offer an incentive program to keep them on track!

Which of these medical claims billing tips do you already use at your practice? Which tricks do you plan on implementing after reading those listed above?

Tell us how you plan on simplifying the process in the comments!

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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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