Many healthcare companies leave a lot of uncollected money on the table because of errors in the billings and collections process. To be fair, this process is extremely complex, with new reimbursement models and processing software updated or released each year. Using a CDM charge master can help reduce the chaos surrounding coding, billing, and collection processes, but there are other ways to optimize your company’s performance in these areas.
Identify Areas of Weakness
When you stop and look at your claims process or go back through areas with substantial errors or omissions, look at the weak links or systems. You need to know the long-term impact on finances in light of denied claims. Look at denial rates and chart your future if no changes or mage. Measure performance in documentation and coding, and review past audits to see if things are improving or staying the same.
Thoroughly Examine the Process
The laws and regulations of healthcare enforce accuracy in coding and billing, and company performance in these areas can be checked with an audit. Using an external auditing service can help uncover areas of concern, but you need to develop a corrective strategy for improvement. You may need to design teams or leaders to oversee the implementation of new plans, keeping employees and processes accountable. Training opportunities will need to be established, especially if you are going to change software systems.
Collaborate With Others
Even though you have a billing strategy in place, you will need to contact the physician’s advisors and other administrators to make sure everyone is on the same page. There could be services that keep getting denied because of outdated codes, yet the front office isn’t aware of these errors. Your communication infrastructure should incorporate all levels of the billing process, from the initial charting down to those who process payment. Delegating work to others can help streamline what need to be done and provides a point-person for specific areas.
Automate as Much as Possible
Human error is always going to be a risk with billing and coding, and software that automates processes has helped to reduce those risks. Automated tracking solutions for valid claims, escalating deadline notification, managing appeals, and identifying trends or weaknesses improves your company’s response and accuracy.
When you leave revenue unbilled or uncollected, your organization will suffer. If this happens, many patients and customers may struggle to obtain the care or services they need.
