As the healthcare revenue cycle continues to evolve, there are constant challenges that need to be addressed and corrected to ensure money and time is being used most effectively. Let’s explore a few ways healthcare organizations may be making mistakes when working with them.
Addressing every single claim. There are still a number of hospitals evaluating each individual claim before they are sent out. If billers are meticulously reviewing all claims even after system edits, it may be time to consider overhauling the system or training a new team.
Not being productive. There will come a time when you’ll need to make a few phone calls and possibly be kept on hold. However, if you’re dealing with a generally low amount of about $5,000 and you’re spending well over half an hour on hold, the use of resources and time is not being maximized. When possible, take advantage of automated options or websites to obtain status on claims or to prepare appeals.
Failing to resolve claim denials each day. It will only become harder to get paid the more time that you wait before resolving claims. These denied claims are not only more difficult to resolve, it can take months before payment is received once the claims have been properly submitted. Keeping on top of denials each day ensures efficient appeals and rebills.
This update is by Medical Accounts Systems, a full-service healthcare revenue cycle management company providing a number of services including insurance follow up and managed care disputes, physician reimbursement, extended business office services, and more. For additional information on our services or for any questions you may have on topics such as hospital bad debt, please call 877-759-6315.