Top 7 Billing Practice Strategies for Increased Revenue in Healthcare

Foundations of Effective Billing

Verify Patient Insurance Eligibility

• Verify patient insurance coverage and benefits to ensure accurate billing and minimize medical billing errors.

• Use automated real-time eligibility (RTE) checks to reduce errors and streamline the billing process.

• Ensure accurate patient information to prevent billing errors and ensure efficient revenue cycle management.

• Verify patient enrollment status and whether the medical practice is a covered healthcare provider.

• Use insurance verification tools to streamline the process and reduce billing errors.

Medical Billing Best Practices

Standardize Billing Procedures and Rules for Staff

• Establish standardized patient billing rules to minimize confusion and reduce medical billing errors.

• Create clear guidelines for coding, claims submission, and payment processes for staff.

• Communicate billing procedures and rules to ensure staff are on the same page.

• Train staff on medical billing best practices, such as enhancing medical coding service and using digital forms.

• Use technology to streamline the process and reduce errors.

Billing Process Optimization

Code Correctly and Ensure Proper Charge Capture

• Assign accurate medical codes to procedures, diagnoses, and services performed to ensure proper reimbursement.

• Comply with coding guidelines, such as ICD and CPT, to ensure accurate coding and charge capture.

• Use medical billing software to streamline the coding process and reduce errors.

• Ensure proper charge capture to prevent lost revenue and minimize billing errors.

• Regularly review and update coding guidelines to ensure compliance.

Claims Management

Submit Claims in a Timely Manner and Follow Up on Unpaid Claims

• Submit claims as quickly as possible to avoid delays and claim denials.

• Develop a routine process for submitting claims to ensure timely submissions.

• Use technology to streamline the process and reduce errors.

• Follow up on unpaid claims to encourage patients to make payments.

• Implement best practices for following up on unpaid claims, such as using automated reminders.

Medical Practices Revenue Cycle Management

Implement Effective Denial Management and Stay Compliant with Regulations

• Proactively set up a structured denial management process to track, analyze, and resolve claim denials.

• Develop a systematic approach to review denials, gather supporting documentation, and submit strong appeals within the specified period.

• Stay informed about changes in medical billing regulations and adjust practices accordingly.

• Ensure compliance with regulations, such as HIPAA, to prevent billing errors and ensure patient satisfaction.

• Regularly review and update billing procedures to ensure compliance.

Patient Communication and Education

Provide Patient Education and Establish a Patient Communication Workflow

• Educate patients on the importance of medical services and the billing process.

• Use patient education to counter negative mindsets about healthcare costs.

• Establish a patient communication workflow to follow up on unpaid claims and provide patient support.

• Provide clear and concise billing statements to patients to prevent confusion.

• Offer patient payment plans and options to improve patient satisfaction.

Technology and Process Improvement

Leverage Technology to Streamline the Billing Process and Improve Efficiency

• Implement integrated EHR and medical billing software to improve reimbursement speed.

• Automate billing tasks, manage claims, and provide billing analytics.

• Use digital forms to collect patient information and integrate it into practice management software.

• Leverage technology to streamline the billing process and reduce errors.

• Regularly review and update billing procedures to ensure efficiency and compliance.