By Michelle Tohill
Maintaining a healthy business practice that profits while at the same time keeps your patients physically healthy can be a difficult task. Because keeping people well requires immediate attention in most cases, your staff may become preoccupied and busy. Businesses can only thrive if overhead, costs, and profits are sustained.
It is necessary to collect maximum reimbursements in order to continue providing exceptional healthcare to your patients. To ensure high cash flow and ongoing profits, practices must have consistent, high levels of reimbursement. Without it, your business will be impacted in multiple ways. You may have to cut or underpay employees which results in poor service. Under-reimbursed practices can create high levels of stress that can be extremely detrimental to the entire business.
One way to guarantee your business remains in the black is to minimize claims denials. An American Medical Association study attempted to estimate how much reworked claims can cost a practice. The results showed that medical offices waste about $14,600 each year on rectifying denied claims through appeals, phone calls, and troubleshooting.
Most practices are already aware of the hindrances that come with successfully submitting claims from their billing department.
Here is some advice on how to avoid losing $14,600 each year:
It is essential for employees to stay updated on any insurance policy changes that could affect patient’s coverage. Your billing department must be attentive for insurance policies regarding diagnostic codes and procedures. Signing up for insurance company emails and newsletters can be beneficial for staying informed. Having good practice management systems in place can also be helpful. These software systems should automatically update new changes on a regular basis in order to guarantee you have all the information for gaining reimbursements.
All denied claims should be investigated to determine why exactly it was denied. One of the most basic reasons claims are rejected is due to the code referenced being incomplete, invalid, or not matching the treatment stated by the physician. As mentioned before, many of these problems can easily be avoided through regular updates. These small coding mistakes can cost your practice thousands of dollars. Other causes for denied claims include timing issues, pre-authorization/authorization mistakes, and authorization period discrepancies. These problems are usually due to the patient not having the correct referral, failing to pay on time, or losing their insurance coverage. Having a practice management system in place can make investigations into denied claims much easier. Leaving denied claims as denied can cost you millions in profit.
Always Recheck Your Work:
Proof-checking your work can be monotonous and prolonging, but rechecking your claims can prevent potential errors. Spending time on this initiative can save time in the future and prevent substantial money loss. Allow your billing department enough time to double check claims or make sure your practice management system notifies you of errors.
Management should fully understand your practice’s billing process. This means being able to follow billing statuses and reports and relating them to the health of your company. Acquiring great technology and providing effective communication are important in achieving this goal.
These four tips can considerably assist practices in reducing or eliminating denied claims. As a result, you begin to receive the maximum reimbursement for your work.
by Michelle Tohill
The software industry is gradually changing from one-and-done licensing purchases like Microsoft Word and Excel to ongoing subscription models in which businesses pay a monthly fee and in exchange get constantly-updated software along with technical support.
This move makes a big difference along a number of factors, including lower start-up costs, lower staff training requirements, and the promise of ongoing software support and improvements.
Many medical practices are moving to subscription-based practice management software. Before jumping on the subscription bandwagon, it pays to compare licensed practice management software to subscription practice management software. By making the right choice up front, you can avoid costly changes down the line.
Licensed Practice Management Software
Licensed software has the benefit of paying just once, up front, with no strings attached. But there are certainly some pretty significant negative drawbacks as well, including:
– high upfront costs
– no support with installation and setup
– no training for employees
– no access to constant updates, and often updates require re-purchase
– little to no customization options for specific needs and customization
Subscription Practice Management Software
With a subscription-based model, you are engaging in a longer-term relationship with your practice management software vendor, and you will be paying on a regular basis for access to the software. The advantages include:
– low up-front costs
– installation and training provided
– access to support team
– trouble-shooting support
– cloud-based, seamless software updates
– customization often available
At Bonafide we have switched entirely from licensed software to a comprehensive subscription model because we believe our customers benefit from the ongoing support and interaction provided with the subscription software model.
Even better, our practice management software is included free with our top-notch billing service. This means that customers get free software with excellent support and they only pay a small fraction of their revenue for it. We think it’s a great model that is benefiting our customers in all sorts of ways. Let us know what you think!
Michelle Tohill is Director of Revenue Cycle Management of Bonafide Management Systems and oversees all billing programs and processes. Her specialty is conducting AR audits to expose inefficient billing practices that fail to fully reimburse physicians for their work. She conducts AR audits and provides Bonafide customers with training and consulting on how to improve every aspect of billing and practice management to maximize revenue.