The gross collection rate in an average hospital in the US is 60% or less. That means for every $1 of services billed, the hospital receives only 60 cents. One of the major reasons for this abysmal rate is the inefficiency of practices to optimize their billing and collection practices amid changing regulatory needs. In fact, as per a recent survey, this inefficiency is forcing healthcare practices in the US to leave about $125 billion on the table each year, which is unacceptable.

With this in mind, we have put together a list of simple tips that will not only give a new lease of life for your hospital billing and collection process, but also increase your revenues by about 70%.

1. Implement Appointment-only Scheduling

An appointment-only scheduling structure gives you the liberty to capture and verify necessary billing information ahead of time. Yes, moving to such setup may be difficult for many public health agencies, but it is a vital step that hospitals shouldn’t hesitate to take if they aspire to clean and optimize their billing and collection processes. And the best way to start making this transition is by allowing patients to fix their own appointments using a self-service online scheduling setting.

2. Verify Insurance Prior to the Time of Service

Verifying insurance a day or two before their scheduled appointment increases your charge-to-collection ratio by manifolds. In addition, it will also give you the liberty to reschedule appointment if there are any issues with the insurance policy.

Opt to use one of the following methods to verify insurance:

  • Insurance verification by telephone
  • Insurance verification by EMR or billing software utilization
  • Insurance verification by online payer resources

Also designate a dedicated resource as your insurance verification specialist, so that he can perform the verification job without any ambiguities or distractions.

3. Collect at Time of Service

Did you know that the probability of collecting reduces by more than 40% as soon as the patient leaves your premises? Hence make sure that you collect coinsurances, copays, past due balances and projected deductibles at the time of service. With this regards, it is advisable to implement a well-rounded check-out process, which essentially gives you an additional chance to collect before the patient leaves your office.

4. Capture Data and Measure Performance

The effectiveness of your billing and collection process will be hampered if, at any point in the process, the individual with access to information is not accountability for his performance. Hence make sure that there is consistent alignment between access to information and accountability for performance by incorporating appropriate monitoring and reporting metrics.

5. Utilize System Intelligence

EMR and other latest advancements in billing software have made it possible to automate daily medical billing functions such as performing charge entry, claims edits and eligibility checking. Hence why bear the burden of carrying out these cumbersome tasks in-house. Leverage the advancements in technology to get more time to focus on your core activities.

6. Clean and Submit Accurate Claims

The accuracy of information that is going out is directly proportional to the reimbursement that is coming in. Or in other words, higher the numbers of claims that leave your practice clean the first time, greater will be the financial stability of your practice. Hence make sure that you submit clean claims, which do not need any additional information for processing, the first time.

How We Can Help?

One of the easiest ways to reduce billing and collection headaches is by outsourcing these tasks to MedBillingExperts. We are one of the leading third-party service providers in the industry with extensive experience in providing end-to-end medical billing solutions to help healthcare providers maximize profits. The thing that differentiates us from the rest is our robustness and adaptability. We also constantly strive to keep abreast with latest updates in billing rules and match evolving regulations. As a result of this 99% of our claims get accepted on first submission. And those rare claims that get denied are handled by our specialized denial management team, which ensures quick resolution.

Contact us immediately and outsource your medical billing and collections requirements.


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