The healthcare industry has evolved at a rapid pace in recent years. The changing spectrum requires satisfactory financial health in medical practices by streamlining their revenue cycles. Any sort of mismanagement leads to a higher ratio of claim denials which inhibits medical claims processing. The Medical Group Management Association (MGMA) has reported that the average […] The post Medical Billing Services Reduce Denials and Accelerate Claims Processing appeared first on Medical Billing Services and MIPS Consultants - P3 Healthcare Solutions Inc.
The healthcare industry has evolved at a rapid pace in recent years. The changing spectrum requires satisfactory financial health in medical practices by streamlining their revenue cycles. Any sort of mismanagement leads to a higher ratio of claim denials which inhibits medical claims processing.
The Medical Group Management Association (MGMA) has reported that the average ratio of claim denials in the healthcare industry of the US is between 5% and 10%. It can be managed with a handful of strategies directed to minimize claim denials and maximize claim approvals.
Healthcare billing solutions are a perfect remedy for these problems, with denial management services providing the required expertise. They also inculcate technology to optimize the processes by addressing the challenges effectively and yield efficient medical claims processing.
Understanding the Problem: Denials and Delays
Various reasons contribute to the high level of claim denials, with coding errors, eligibility issues missing information, and unable to fulfill payer requirements being the pressing ones. They inhibit revenue collection which can be increased by efficient denial management services.
Advantum Health states that, as reported by the Advisory Board, 90% of the claim denials can be prevented, but still many healthcare providers fail to decrease them. It is because they don’t have enough resources to implement medical claims processing, thus increasing staff burden and decreasing cash flow.
The Role of Healthcare Billing Solutions
Medical billing solutions provide the necessary specialization to manage the complexities of the revenue cycle management for medical practices. It involves all the steps from patient registration to final payment. The following roles are crucial in minimizing denials and increasing clean claims:
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Expertise in Coding and Compliance:
Error-free coding is very important to decrease the number of denied claims. It can be done with the help of specialized medical coders hired by healthcare providers. They guarantee the use of standardized code sets such as CPT, HCPCS codes, and ICD-10 to a secure billing statement.
According to a study published in the Journal of AHIMA, medical practices who avail of the services of certified medical coders experience a denial rate that can be as low as 25%. It results in an increased level of smooth medical claims processing yielding more revenue and additional patients.
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Advanced Technology and Automation:
Medical billing services use the most advanced billing software and computerization tools to modernize the payment processes. These tools perform many functions, among them are the identification of coding errors before the final submission, verification of patient’s eligibility, and the tracking of medical claims processing.
A statistic by Black Book Market Research tells that around 90% of medical practitioners use advanced revenue cycle management for their practices. It helps them report an improved level of clean claims, ultimately leading to faster and higher payment collection.
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Denial Management Services and Analytics:
Another benefit of healthcare billing solutions is results-driven denial management. It helps in identifying the patterns causing claim denials and replacing them with correct ones. Medical billing services help develop selected solutions to target the problem-causing factors.
According to a report published by the Healthcare Financial Management Association (HFMA), providers spend around $25 on one claim as its denial resolving cost. It underscores the need for clean medical claims processing to reduce the number of denied claims.
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Compliance with Changing Regulations:
Frequent changes surface in the coding standards and the requirements of the insurance providers. It keeps the landscape of the healthcare industry in the US continuously evolving. Healthcare billing solutions should always be updated to ensure standard medical claims processing and reduce denials.
Benefits of Partnering with a Medical Billing Service
The following are the benefits of partnering with a billing services provider that ensures errorless medical claims processing:
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Improved Cashflow:
Healthcare billing solutions guarantee clean claims processing that results in on-time payments, thus increasing revenue collection and giving more time to healthcare providers to focus more on patient care to increase their satisfaction with the services rendered.
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Cost Savings:
Availing of healthcare billing solutions diminishes the need for staff permanently based in the clinic or the hospital. It also reduces the need to make additional investments in technology, reducing the cost of administrative tasks. As per Grand View Research, healthcare providers can reduce up to 30% of the operation costs.
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Enhanced Patient Satisfaction:
Clean medical claims processing prevents the patient from getting frustrated due to a delayed billing process. The delay in the subsequent reimbursement can be a result of errors in the billing codes. Thus, minimum billing errors lead to a higher level of patient satisfaction.
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Scalability and Flexibility:
Medical billing services scale the operations of the practices by matching their growth needs. It involves managing the billing codes as per the correct and complete patient information and handling revenue cycle management for medical practices according to fluctuating demands.
Conclusion:
Denial management services are essential to streamlining the revenue cycle of medical practices. By availing of healthcare billing solutions, revenue cycle management for medical practices can be done easily by using expertise, relevant strategies, and updated technology.
As a result, enhanced medical claims processing fastens the reimbursements to ensure patient satisfaction and boost the growth of medical practice. It requires necessary upgradation of the billing processes which can be done by outsourcing medical billing services.
The post Medical Billing Services Reduce Denials and Accelerate Claims Processing appeared first on Medical Billing Services and MIPS Consultants - P3 Healthcare Solutions Inc.
