Keeping Revenues Flowing With Efficient Medical Billing

by  Find-A-Code™
Aug 3rd, 2023

Driving revenues are part of the business side of medicine. But they are only half the equation. Driving revenues offer limited value if poor billing practices do not keep them flowing in. So in addition to developing strategies for increasing revenues, providers need to give significant attention to efficient medical billing.

Medical billing begins with medical billing codes. Clinicians rely on the codes to indicate services provided. Hospitals use the codes to designate services, medical devices, drugs, tests, and more. The codes lay the foundation for billing both private and public payers.

What does this have to do with keeping revenues flowing? Everything. In order to keep reimbursement from payers coming in, bills need to be submitted correctly and on time. Efficient medical billing leads to a constant flow of reimbursements. Likewise, inefficient billing practices slow down reimbursements and interrupt revenue streams.

Do Not Underestimate the Importance of Training

Efficient medical billing relies heavily on technology. But before technology comes training. As an organization with plenty of experience in medical billing codes, we can tell you that there are literally tens of thousands of codes in the modern healthcare environment. The most common are ICD-10 and CPT codes. But there are other code sets in play.

Training is designed to familiarize those involved with code set basics. Of course, no one is expected to memorize every code in every set. That would be an impossible task anyway. But training does include knowing how to look up and apply codes correctly. A properly trained employee would know the basics of diagnostic code lookup, for example.

Rest assured that it is not just medical coders and billers who need training. So do clinicians. Their training doesn't need to be as in-depth, but they still need to understand the coding system in its basic function. Otherwise, clinicians make it harder for coders and billers to do their jobs correctly.

Accurate Information Increases Efficiency

Second only to training in terms of importance is accurate information. It goes without saying that coders and billers need to make a point of using only up to date resources when looking up codes. Beyond that, patient information needs to be accurate as well.

Efficient medical billing dictates that insurance information be updated on every visit. Likewise for patient name, address, and contact information. Even National Provider Identifier (NPI) information should be verified on a regular basis. NPI lookup is simple enough, so there is never an excuse for it to be wrong on medical claims.

Timely Submissions Equal Timely Payments

Regular training and accurate information lead to more accurate claims. To ensure those claims are paid on time, they need to be submitted in a timely manner. This gets tricky thanks to private payers having their own policies. Nonetheless, what constitutes a timely submission should never be taken for granted.

Efficient medical billing dictates that billing departments know and understand their schedules. It dictates that bills are submitted far enough in advance to allow time for correcting any errors that might arise. Pushing claims to the very last minute doesn't leave that extra time. It also puts unnecessary pressure on coders and billers, pressure that can lead to errors.

Whether you are talking about a hospital, group practice, or any other type of healthcare facility, revenues are tied up in medical billing. It is one thing to develop strategies for increasing revenues year after year. It's an entirely different matter to put the time and effort into medical billing to make it as efficient as possible. Medical billing efficiency keeps revenues flowing. It is just as important as driving revenue growth.