The Top Tips for Medical Billing

If you are looking for a way to maximize your revenue in the medical world, you need to pay attention to your medical billing and coding practices. If you do the job, you need to make sure you get paid for it. Unfortunately, a lot of medical providers do not collect nearly as much money as they should because of issues with the billing and coding process. Even though it is not the most exciting part of medicine, it is very important. After all, if you do not collect enough money to keep the lights on, you will have a difficult time providing the right level of care to your patients. Take a look at some of the most important steps you need to follow if you want to maximize the results of your billing and coding.
 
1. Document Everything

First, you need to make sure that you document everything. In medicine, there is a saying that if you do not document it, then it does not happen. Even though you may have done everything necessary to take care of the patient, the insurance company will not believe you if you do not write it down. Even though it can take a while to document everything, you need to do so if you want to maximize your chances of getting paid. If you want to save time on your medical documentation practices, you may want to think about hiring a scribe who can help you.

2. Train Your Staff

Speaking of hiring a scribe, you need to make sure you train your staff well. There is a good chance that you are not going to be responsible for handling every single bill that you send to the insurance company. You are going to be relying on your staff to do this for you. If you want to make sure that your claims are accepted, you must make sure that you train your staff appropriately. Make sure your staff understands the most common codes that you use, and make sure they understand when to apply specific codes. This will make it easier for you to get paid on time.

3. Understand Prior Authorizations

Keep in mind that there are specific procedures that may require you to obtain a prior authorization. This means that instead of asking for approval on the back end, you will ask for approval on the front end. Before you order an MRI for a patient, the insurance company may ask you to call them to get an authorization for that procedure. Different insurance carriers have different policies, so you need to make sure you understand when you need to get a prior authorization for certain medications and procedures.

4. Know Your Carriers

Speaking of insurance carriers, you need to make sure that you get to know them. You are probably going to deal with a wide variety of insurance companies. You may have your private insurance carriers, such as Blue Cross Blue Shield. Then, you will probably have your government programs, such as Medicare and Medicaid. All of these are going to be different, and you need to make sure you understand the rules you are playing by if you want them to pay you for your services. Take a look at the details of each insurance carrier, and make sure you file claims that have a high chance of being approved.

5. Consider Outsourcing

Ultimately, all of this is a lot of work, so you may want to consider outsourcing it to a third party. Even though you will have to pay that third party to handle your billing and coding for you, it may be worth it if you get a higher percentage of your claims accepted. If you feel like you have enough business to warrant outsourcing this to another organization, you should consider the options carefully. That way, you know that you put your practice and your patients in the best position possible to be successful. There are certain situations where outsourcing your billing and coding operations might be the best option for your practice.

Get the Most out of Your Billing and Coding Practices

 
Ultimately, these are just a few of the most important points you need to keep in mind if you are looking to maximize the revenue you generate from medical billing and coding. There are a lot of medical fields where it is not viable to simply not accept insurance carriers. If you are forced to work with insurance companies, you need to make sure you maximize your chances of your claims getting accepted. Remember that this is not something that you need to go through on your own. If you would like to get more out of your medical billing and coding, reach out to a professional who can help you.
 
This is a guest blog entry.