The process of medical billing is complex, and it demands a team that is both aware of its surroundings and attentive to its details in order to be successful. However, having the appropriate technology is also important. If you are still using paper-based procedures and going through physical files, your business is not running at its most efficient level, and you may be missing out on key possibilities to follow up on claims.

Keep Claims Clean & Accurate 

Claims processing that is both clean and accurate requires an efficient practice management system as a prerequisite.

The ability to sustain a positive cash flow is critical to the long-term financial health and profitability of any healthcare practice or provider of healthcare services. It is essential that payments not be delayed, misplaced, or refused in order to maintain the ability to care for patients and pay for necessary expenses.

You will begin to see the benefits of increased first-pass acceptance rates as well as faster billing cycles after you have the appropriate software and a staff that has received extensive training. But even if everything goes according to plan, there is still a possibility that some claims will be turned down.

Over half of the claims that are refused or rejected are never redone, despite the fact that these denials or rejections could be the result of minor errors. This indicates that the typical healthcare professional is leaving unclaimed funds worth thousands of dollars on the table on an annual basis.

Facilitate Financial Stability 

Keeping a good cash flow is one of the most important things that can be done for the long-term financial health of any provider of healthcare services. In order for the hospital to continue providing necessary patient care services, it is necessary for there to be a consistent flow of revenue into the institution, and the A/R department sees to it that this continues to be the case.

Improve Your Revenue Cycle

Clearly, the next step in enhancing your revenue cycle is to follow up on any claims that have been submitted. The importance of following up on claims can be broken down into these five categories.

• It is much simpler to collect payments on time if you have a system in place that can rapidly identify and recover past-due payments. This makes it possible to recover payments that have been missed.
• Claims that have been denied can be handled; if you have the ability to flag denied claims, you can discover the cause for the denial and correct any errors that were made.
• You can immediately make the appropriate modifications and then immediately submit a fresh claim request rather than having to wait weeks for the payer to provide a reason for the claim being denied.
• It is possible to recover claims that are awaiting additional information; however, in some cases, the waiting period for these claims is made significantly longer because extra information is required.
• The billing cycle can be kept uninterrupted and revenue can continue to flow smoothly if proper follow-up is performed.

Minimizes Accounts Oustanding 

The most important goal of A/R management is to reduce, to the greatest extent possible, the amount of time that accounts are permitted to stay overdue. The team monitors the status of accounts that have not been paid, determines the appropriate course of action necessary to achieve payment, and develops and implements procedures to secure payment.

Claims Never Get Missing 

The lack of the claim being received is the primary factor contributing to the delay in payments. In most cases, this occurs when the paper claims are misplaced. It is recommended that the claims be sent in an electronic format so as to avoid this situation. If you have already followed up on the claim and you are aware that the claim has not been received, then it will be much simpler for you to send a new request for the claim as soon as possible.

Helps in Recovering Overdue Payments 

The lack of the claim being received is the primary factor contributing to the delay in payments. In most cases, this occurs when the paper claims are misplaced. It is recommended that the claims be sent in an electronic format so as to avoid this situation. If you have already followed up on the claim and you are aware that the claim has not been received, then it will be much simpler for you to send a new request for the claim as soon as possible.

Wrap Up!

Simplifying your medical billing process and automating the resubmission of rejected or refused claims is crucial to the success of any business. Schedule a free consultation now if you’re ready to learn how Aplus RCM gives the tools your practice needs to grow.

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