Loss profit and break even

RCM Optimization

/in , , /by

Today’s blog is shared from the President of MCAnalyTX’s, Eric Depew, an expert and leader in consulting on outsourced Revenue Cycle Management Services, Healthcare Claim Management & Contract Modeling Solutions. To learn more about MCAnalyTX’s Inc., visit their website at  https://mcatx.com, or reach Eric Depew at (281)920-0300 ext 101

 

Healthcare revenue cycle management is the process of managing billing, coding, and collections basically every aspect of the healthcare organization. RCM is a process that directly impacts your organization’s financial performance.

Revenue cycle management services can help improve your organization in terms of revenue, while also reducing denials, appeals, and follow-up work. Within this article, we will discuss the benefits of outsourcing your organization’s RCM. We will also outline some of the common questions about outsourcing and the process.

First, and foremost in order to be successful, a healthcare organization must process claims in a timely manner, while ensuring that patients are aware of what they owe, and what they pay. The goal of outsourcing RCM is to increase patient collections, and reduce bad debt, all while improving patient satisfaction and care. One of the most important parts of revenue cycle management is reimbursement. In fact, it makes up about half of a hospital’s operating revenue.

What does reimbursement mean?

Simply put, it means getting paid for your healthcare services. It is the process by which a hospital, practice, or clinic receives payment from a third-party payer for services provided to patients. The payer – either a private insurer or a government program like Medicare or Medicaid then reimburses the organization for the services rendered on a negotiated reimbursement basis.

Healthcare organizations can save millions of dollars by utilizing RCM services.

RCM outsourcing saves you money by:

  • Reducing administrative costs
  • Increasing cash flow through faster reimbursement
  • Increasing revenue by ensuring all claims are processed accurately
  • Reducing bad debt and bad debts recovery costs
  • Reducing the number of claims denials and appeals
  • Increasing revenue by identifying errors
  • Improving cash flow

RCM provides a framework for optimizing your revenue cycle performance. The goal is to reduce organizational costs, and improve cash flow, and patient satisfaction.

Get pid the importance of medical documentation

The importance of medical documentation

/in , , , , , /by

Medical documentation is necessary to claims being paid quickly

In today’s healthcare world you need to develop the necessary organizational controls to develop successful processes and procedures in order to stay compliant and financially healthy.  The key to excellent documentation is knowing what is required and what is not. Medical reimbursement comes only from what you have documented if something is not written down it did not happen.  This documentation is also a crucial form of communication. The importance of writing complete, concise, dated and timed documentation cannot be stressed enough. It is not only how you are reimbursed, but legal protection and critical communication.  In the event of a medical malpractice lawsuit the only tools you will have to work with is what has been recorded.

Insurance checklist complete concise date time

Accurate documentation begins with gathering patient information from the very first point of contact, and continually updating as the patient moves through the healthcare process.  Using verification tools will enable you the insight to see how you will be paid for services, and which services and procedures will require further approval from their healthcare provider.  Medical documentation is telling the patient story and applying the correct billable codes. Once services have been rendered it is the facilities responsibility to transcribe said services into billable charges. With clear and concise documentation, you can assign medical billing codes to the claim. These billable codes are the vehicle to revenue.  They are inflexible and must be followed to maintain a healthy bottom line.

Understanding the importance of good documentation is crucial to all aspects of the medical record.   Documentation is more than legal protection.  Medical records are a vital form of communication, and the importance of accurate and dated communication cannot be reiterated enough.

Communicate the treatment plan

Good documentation promotes continuity of care through clear communication with all that are involved in patient care.  This is a way to communicate your treatment plan to other providers for the patient.  This level of communication ensures the highest quality of care.

It’s a legal document from the medical provider

A medical record is a legal record of services rendered by the medical provider. Once written it is permanent.  In case of legal proceedings written documentation is called upon and reviewed to help support an argument either way.  So again clear, concise documentation is crucial to every step of the process.

It’s a document of medical services for the insurer

Medical documentation tells insurance providers what they are paying you for.  Each case is coded and translated into a cost for your practice.  Thorough documentation of all medical issues and treatments is therefore critical to your bottom line.

How do I get paid by insurance?

Your documentation is a process of taking all that is written and identifying it as a diagnosis’s, medical tests, treatments, and procedures for medical insurance. This information is then transcribed into standardized codes. These codes are what are then used to bill government and commercial payers for reimbursement of services rendered.

Information you need to get paid verification of benefits, assessment, date and time, treatment plan, procedure, diagnosis, billing codes

Medical billers are the professionals in charge of processing patient data, which would include treatment records, medical plans, and all related insurance information. Medical billers work to ensure that you, the healthcare provider is accurately and efficiently paid for the services performed.

A full understanding of medical insurance, the claims process, the appeals process, and the impact on your revenue cycle gives the medical billing professional the necessary knowledge to maximize revenue performance.  The financial health of your practice depends on the effectiveness and overall performance of the billing office.

Let’s take  look at your revenue cycle.  Revenue cycle management is an invaluable part of a successful healthcare organization.  Without a trustworthy and efficient billing company, you would be losing out on thousands of dollars in payer reimbursements, patient payments, that your practice depends on.

Understanding and executing an outstanding revenue cycle is an integral component of success.  We have all heard of location, location, location for successful real estate endeavors well for successful revenue cycle management it comes down to documentation, documentation, documentation.

 

Testimonial-slider

5 Ways That Software Can Help You Grow Your Practice

/in /by

You know that growth is essential to your success if you’re a business owner. You need to expand and improve to stay ahead of the competition constantly. One way to achieve this growth is by using helpful software. Good software can help you automate tasks, improve communication, and increase efficiency. We will discuss five ways that software can help you grow your practice. 

1. Prescription Software 

One type of software that can help you grow your practice is prescription software. This tool helps doctors electronically prescribe their patient’s medications. It also allows them to renew and cancel prescriptions. This is a great tool that benefits patients because they don’t have to worry about filling their medication at their pharmacy. All aspects are taken care of by the medical practice’s staff, and the patient just needs to pick up the medication. 

2. Patient Portal 

Implementing a patient portal is another way software can help you increase business. A patient portal allows your current patients access to their medical records and test results, so they don’t have to call your office every time they need an update on their condition. Some portals even allow your patients to schedule an appointment.  

3. Outsource Medical Billing 

While outsourcing your medical billing may not be necessary, it can save you a lot of time and hassle. If your staff spends 40 hours per week on medical billing, you could spend more time on office procedures. If office procedures aren’t yielding enough business, though, then missing out on potential revenue is also an issue. You can outsource medical billing services to a reliable medical billing company regardless of if you need help full-time or just occasional assistance. 

4. Electronic Health Records 

Implementing an electronic health records system can save time and improve your patients’ quality of care. An automated system will keep track of patient information, so it doesn’t have to be updated repeatedly. This also alleviates the risk of human error. Electronic health records can make it easier to schedule follow-up appointments, which will lead to more revenue. 

5. Scheduling 

Scheduling is another area where software can help you save time, improve efficiency, and increase revenue. While many practices still utilize paper to schedule patients, scheduling software can automate this process, ensuring there are no missed appointments. The scheduling system will send reminders to the patient by email or text message that their appointment is coming up. You may also find that utilizing an online appointment scheduling system will help you book more appointments because it is available 24/7. 

Conclusion 

Above are just five ways software can help you grow your medical practice. The software can be customized to meet the specific needs of your business, so if you think about what issues your practice faces and what could be improved upon, you can come up with additional ideas for how software can help you grow your practice. 

5 Benefits of Outsourcing Your Medical Billing

/in /by

As a result of the COVID outbreak that shook the world in 2019, new technologies have drastically reshaped the medical field. Electronic health records have replaced the manual administration and manner of operation, which include everything from networking portals to test findings to effective medical billing systems. Technological advancements have profoundly altered the method in which billing services are provided. 

There are strict billing processes for both the payer and the user of healthcare services. It can streamline the medical billing process and enhance income and efficiency by employing the correct medical billing service or healthcare billing strategies. 

In this article, experts of Integrity Billing will help you learn how a medical billing service will benefit your facility the most. So, let’s begin! 

5 Benefits of Outsourcing Your Healthcare Billing Service 

1. Help You Adhere to HIPAA Rules 

First and foremost, be sure that the Medical Billing Service you choose complies with all applicable HIPAA regulations. Legal software products are governed by HIPAA, the Health Insurance Portability and Accountability Act (HIPAA). HIPAA safeguards patients’ privacy, ensuring that healthcare practitioners remain anonymous. One of the most important advantages of allowing patients to see their hospital documents is improving data systems. 

You may avoid dealing with compliance issues, rejections, and other office hassles by outsourcing your medical billing to a reputable supplier. This frees up your time for other important daily responsibilities. 

2. Free You From the Worries Of The Analytics Reports 

Back in the day, when businesses would outsource medical billing, they would lose control over the financial data required to manage your business. The information provided by your biller was all you needed to determine the financial viability of your practice after outsourcing. This means you can’t utilize the reports for immediate changes or proactive decisions because the data will be out-of-date by the time you receive them. 

A good medical billing service will free you from all the aforementioned worries. They will understand and portray the notion that if you’re spending money on medical expenses, you should be able to see all of your company’s financial information. Your medical billing company should make it easy for you to get immediate access to this data from any device or location at any time. If you’re looking to grow your practice or change your marketing approach, this kind of information might be quite helpful. 

3. Efficient With Software Management 

If you outsource a proficient medical billing company, they will help you with the correct RCM software, which means that your firm’s operations and RCM processes will be streamlined and error-free. In this way, before meeting a patient, coders and billing staff have direct access to the patient’s data, insurance details, and clinical information; disputes are received and handled right away rather than accumulating in a pile. You’ll be in complete compliance with all HIPAA data storage standards if you store your data on the cloud. 

We believe that the cost of the software should be taken into consideration. One medical insurance billing company might charge for these services differently than others. You and your practice must make the best financial choice possible. When searching around, compare the various providers’ offers, costs, and payment terms. 

4. Quick at Insurance Verification 

You must be able to review and verify the insurance status of every patient from the software provided by the medical billing company. As a result, regular insurance status verification might save you time and speed up the procedure. Consequently, doctors can better assist their patients because the confirmation procedure has been shortened. 

5. Expert at Their Job 

With revenue cycle management’s ever-changing requirements, even the most skilled, qualified, and devoted medical billing personnel may have difficulty keeping up. You’ll need a medical team with the knowledge and experience to advocate for your best interests. The best medical billing company should answer all of your questions quickly and easily. 

It is essential to outsource medical billing duties to the appropriate healthcare billing agency to build and sustain a successful medical practice. Regardless of your expertise or unique needs, having the right medical billing services may assist bridge the gap between a seamless billing procedure and improved revenue cycle management. 

Integrity Billing is one of the top medical billing service providers with proven results of less loss and more revenue. Thanks to our custom-made solutions, improved revenue management procedures and faster reimbursements are available. Find out how we can enhance your medical billing by contacting us right away! 

Medical Billing

The Most Frequent Medical Billing Errors That Companies Make

/in , /by

Medical billing errors are prevalent and can happen to any company. They often stem from a lack of understanding of the medical industry or insufficient staff who know how to code properly, especially in the medical billing companies. There are many ways to reduce these errors, but it is important to be proactive before your customers start complaining. At Integrity Billing, we specialize in billing and other healthcare management services. This blog post will discuss the most frequent medical billing errors companies make – some you might be making yourself without even realizing it.

1. Not understanding the medical industry.
This is one of the most common medical billing errors companies make. They may not understand what services are covered by insurance, how to code procedures properly, or what is considered a reimbursable expense. All of this can lead to mistakes when submitting claims and result in lost revenue for your company. However, outsourced medical billing services can help solve this problem.

2. Failure of verification of benefits for insurance.
Another common mistake companies make is failing to verify insurance coverage. Before submitting a claim, it is important to make sure that the patient’s insurance plan covers the service you are providing. If it’s not, you could be on the hook for the full cost of the procedure.

3. Not submitting claims on time.
This medical billing error can often be attributed to a lack of staffing or understanding of how the system works. When claims are not submitted on time, you run the risk of them being denied due to insufficient documentation. And if they are denied, you will have to resubmit them. However, an outsourced medical billing service provider can help solve this mistake.

4. Incorrect coding.
This is one of the most common medical billing errors and can lead to significant financial losses for your company. Incorrect coding can result from not having enough staff familiar with medical coding guidelines, or it could be due to human error. Either way, it is important to have a system to check coded claims before submitting them to ensure accuracy.

5. Not following up on denied claims.
If an insurance company denies a claim, it is important to follow up on it as soon as possible. Often, all you need to do is provide additional documentation, and the claim will be approved. However, if you don’t follow up on denied claims, you could end up losing money.

6. Filing duplicate claims.
This medical billing error often occurs when companies submit duplicate claims for already billed procedures. This can be a costly mistake, leading to claims being denied and additional administrative work.

7. Not verifying patient insurance eligibility.
It is important to verify that the patient is eligible for coverage before providing services. If you provide services to someone who is not covered by their insurance plan, you will be responsible for the full cost of the procedure. Therefore, verification of benefits is essential to ensure the eligibility of patients.

8. Failing to follow up on unpaid bills.
Often, bills go unpaid because patients forget or don’t have the money to pay them. Therefore, it is important to follow up on unpaid bills on time to get paid what you are owed.

These are just some of the most common errors that medical billing companies make. By being aware of these mistakes and taking the necessary steps to avoid them, you can ensure that your medical billing process is as accurate and efficient as possible. If you are looking for more tips on how to improve your medical billing process, contact Integrity Billing.