Does Your In House Team Lack Deep Insights Into The Revenue Cycle?
Irrespective
of the size of the services they provide, many healthcare facilities have been
grappling with failure to manage their revenues with the in-house team. It is
quite possible that despite all the efforts that the in-house medical billing
and coding team is putting into managing the revenue cycle ends up with nothing.
The failure is not because they are reluctant to do the job but due to the
insights caused by the multiple changes and disruptions in the medical billing
system.
Added
to this, they face continuous obstacles when it comes to payment collection due
to the changed behavior of the patients and the insurance providers. Often
ignoring all these, the in-house team struggles with the revenue cycle
management resulting in the practices to upend their business to stay afloat.
So
if your in-house medical billing and coding team is also constantly fighting to
keep the revenue cycle on track, miserably failing can be due to any one of multiple
of the following reasons-
1. Lack of training
Most
of the medical
billing and coding companies fail to provide constant training to their
staff and upgrade their knowledge about the changes related to medical billing,
coding, reimbursements, and insurance policies. In addition, as more
experienced staff exits the practice, the necessity of training diminishes with
the focus on how to work out the staff deficit along with working with the
inexperienced staff.
The
result is getting the wrong information. Also, the inefficiencies are starting
to take a toll on the revenue and practice.
2. Not validating the information
The
in-house medical billing and coding department is the first line of contact in
getting the correct data. The staffs need to know the changes that can be made
before submission. For each claim, they need to know the information to be put
in to ensure it is acceptable to the payer.
In
fact, any data or claim protocols that are not working need to be identified
immediately by the in-house medical billing and coding department to ensure the
claims are handled correctly and are not getting rejected. Further, they need
to work constantly with the payers and other team members of the practice to
check the data that is not working and might be overlooked by the management.
3. Failure to monitor data
The
in-house team must be trained to identify and correct any billing errors before
submitting them. When they fail to monitor these errors, the result is an
increase in denials and a decrease in revenue. Hence, any training material you
have for the in-house revenue management team needs to be updated constantly,
which will reflect the changing protocols in the medical billing and coding
system, the changes in the policies of the insurances, and a scrub. Including
the scrub would also allow the team to monitor and make the correction and
necessary modifications before the claim so it doesn't get denied.
Any
lack of implementation protocols would mean a continuation of denials and
damage to the revenue cycle.
4. Failure to work the denials
Despite
doing all the good work, denial is something that will happen once in a while.
It has been a constant battle for most of the facilities and often forces them
back to go old school of tracking the confirmation, faxing the details, or
finding a solution that can be done to receive the payment. But all these mean
losses of labor, time, and delays in the payment, affecting the overall
long-term revenue.
5. Not understanding the payer contracts
Payer accountability is one of the critical
areas that help manage the revenue cycle. The staff's job is to monitor and
understand the contracts, do a regular audit, and ensure the payer is upheld. It
would be a rare situation when a payer will contact you for the underpayment or
notify renewal timeframe.
But
with the right billing software in place, reports can be extracted to recognize
any negative behavior by a payer. This data can be used to act upon to manage
the revenue.
How to Get Out of the
Cycle of Failure?
One
of the best ways to ensure that your in-house medical billing and coding team
is not dragging you down regarding revenue cycle management is by outsourcing
the entire procedure to the experienced team of 24/7 Medical Billing Services.
24/7
Medical Billing Services is one such organization that manages the medical billing
and coding of medical service providers and ensures the revenue collection is
on time. In addition, intelligent insights are offered with a proper data
collection system.
Also,
there is very less scope for claim rejection
due to the trained and dedicated staff to take care of the billing system with
due follow-up for every claim. 24/7 Medical Billing Services as the medical
billing partner will create a profitable revenue cycle management while the
practice can focus on patients and the in-house team on other administrative
works.
About
24/7 Medical Billing Services:
We
are a medical billing company that offers ‘24/7
Medical Billing Services’ and support physicians, hospitals, medical
institutions and group practices with our end to end medical billing solutions.
We help you earn more revenue with our quick and affordable services. Our
customized Revenue Cycle Management (RCM) solutions allow physicians to attract
additional revenue and reduce administrative burden or losses.
Contact:
24/7
Medical Billing Services
Tel:
+1 888-502-0537
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