6 Mistakes You Might Be Making in Billing Management & How You Can Start Fixing Them

Billing management errors can cost you money and time. By identifying some of the problems you might be creating, you can find solutions that will strengthen your process and improve your bottom line. Check out these six mistakes you might be making in billing management and suggestions on how you can start fixing them. 

Poorly Thought Out Financial Policy

A poorly executed financial policy can mean you’re missing out on vital revenue and confusing patients. This lack of proper planning can shrink collections and cause AR headaches. 

By drafting a straightforward and easy-to-understand patient financial policy, you take a crucial step in the patient revenue cycle. It is an opportunity for a practice to communicate their financial expectations to the patient and document their understanding. The more knowledge, the better. 

Recommended Actions:

o Create a clear and precise policy that details collection processes and methods.

o Establish a financial billing agreement that all patients keep a payment method on file.

Inaccurately Collecting Patient Information

Whether you are billing an insurance provider or collecting payment from a patient, gathering accurate information is the first step of the process. Failing to collect all the patient information from the start of a visit can lead to time and money spent down the road. It also delays revenue as you try to chase down information from a patient. When you gather all necessary patient information upfront, you can avoid many mistakes along the way.

Recommended Actions:

Create a form that is easy to fill out (either hard copy or digital). It should include boxes for all the information you need from a patient to bill properly:

• Address
• Copy of driver’s license
• Cell phone
• E-mail
• Hardline phone

Additionally, you should:

• Obtain copy(s) (front & back) of insurance card(s)
• Obtain complete contact information
• Have payment option on file: CCOF – credit card or ACH
• Re-confirm contact info with recurrent patients

Failing to Follow-Up On Patient AR

Think of patient AR as another payer. Instead of contracting with the payers, you are contracting with each patient. A failure to take care of payment at the office visit means you have to follow up, wasting valuable and limited resources. And if you don’t have an automated system to send reminders, you’re going to miss out on revenue for services rendered. Meanwhile, your AR starts to grow. 

Recommended Actions:

• Add card reader machines at the check-in desk to eliminate wasted time keying in credit card information and provide instant verification.
• Enhance your collections process with the latest medical billing technologies, such as the automated revenue management tool, to set up reminders for payment.
• Keep credit card records for patients to speed up the payment process.

Not Having A “Click to Pay” Option

Patients always look for convenience, especially when paying a bill. To improve the patient experience and collect payments faster, create an easy payment process. Letting a patient know they can pay instantly online can alleviate many headaches. 

Recommended Actions:

• Add a simple but striking PAY HERE button directly on your homepage with a link to your pay portal to make payments easier for your patients. But make sure: 
  • It integrates with your practice management system for smooth payment posting.
  • Patients can self-update insurance or CC information within the link to pay.

Not Having A Collection Agency Policy

Many providers are cautious about utilizing a collection agency, as they want to protect their relationship with patients. But if patients are not making timely payments, a collection agency can help bring in expected revenue and set clear expectations with patients. A lack of a clear policy can lead to confusion, anger, and distrust from valued patients. 

We see many instances where customers follow up on unpaid balances once an agency sets clear expectations, thus minimizing the number of bills that agencies need to send to collections and increasing revenue.

Recommended Actions:

Create a clear policy that informs the customer that the services provided require in-office payment or the provider must take further action.

Poorly Trained Staff

When the efficiency and profitability of your revenue cycle are at stake, you need expert billers on your team to ensure your facility’s success. An untrained staff means coding mistakes, lack of AR follow-through, and declining collections, which costs you valuable revenue.

Recommended Actions:

Your staff will still need consistent training to stay up-to-date on the latest technologies and coding regulations.

• Lack of consistent training is an overlooked aspect in offices. Many staff members receive one-time training with no annual follow-up.
• Your processes are only as good as the people implementing them.
• Regular training will keep staff educated and allow you to share innovations.

Never miss a billing mistake again with Coronis Health’s billing management checklist.

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https://www.coronishealth.com/blog/6-mistakes-you-might-be-making-in-billing-management-how-you-can-start-fixing-them/

Affected by the Labor Shortage? Coronis Can Help

Health care facilities are under constant pressure to reduce costs and improve productivity—to do more with less. The increased demands and staff shortages brought about by the COVID-19 pandemic have further exacerbated an already challenging situation. 

In a tight health care labor market, your ability to maintain continuity of patient care with manageable staffing levels may be compromised. Coronis can help. We can evaluate your facility’s requirements and bring in the cost-effective talent you need in an efficient and scalable way.

What the Numbers Show

Hospitals are at the center of a national staffing shortage due to a combination of high COVID-19 patient volume and staff departures during the pandemic. Still, there is little national data available to quantify the shortages’ impact on patient care.

The first indication came in the form of a CDC report indicating that healthcare-associated infections would increase significantly in 2020 following years of steady decline. The researchers attributed the increase to pandemic-related challenges, such as staffing shortages and high patient volumes, which made it difficult for hospitals to follow standard infection control practices.

For example, the Joint Commission received 569 reports of sentinel events in the first six months of 2021, up from 437 in the first six months of 2020. However, meaningful conclusions about the events’ frequency and long-term trends cannot be drawn from the dataset. The Joint Commission estimates that fewer than 2% of all sentinel events are reported to the organization.

The Safety Impact of Labor Shortages

Nurses, physicians, and other health care professionals are leaders in patient safety. They’re the people who interact with patients daily—advocating for patient safety and making decisions and taking actions to promote safety.

There’s no doubt that workforce shortages in healthcare facilities can negatively impact patient safety. Research has found that labor shortages in hospitals exist across a broad range of occupations and specialties—from registered nurses and licensed practical nurses to respiratory therapists and paramedics. 

Improving the Revenue Cycle

Many healthcare organizations have adopted lean principles to lower costs, decrease waste, and improve the quality of care.

Tightening up revenue cycle management (RCM) is a crucial part of many lean initiatives. Improving the revenue cycle is not just a cost-cutting measure; it has the added benefit of increasing revenue to secure additional staff and resources. 

Revenue cycle management allows health care organizations to concentrate on improving efficiency so they can spend more money on attracting and retaining top talent. 

When you outsource routine RCM functions such as registration, billing, collections, denial management, coding, and insurance eligibility verification to Coronis, you can focus on hiring  only medical and clinical staff, rather than administrative staff as well. With fewer employees to manage, you can focus on your facility’s clinical needs rather than on financial pressures and performance, which your RCM partner can handle.

Outsourcing May Be Your Best Friend

No matter your line of work, competition is tough. This is especially true in the healthcare field. The system is already stressed, and with an aging population and a limited number of medical practitioners, the job market is becoming increasingly tight with higher demand and fewer resources.

This means that you may need to think outside the box regarding hiring practices. A viable alternative is to outsource certain functions if you feel that you can’t keep up with the growing workload or can’t keep up with the quality of care that patients deserve from your facility.

Outsourcing has become increasingly common in the healthcare industry. According to the Society for Human Resource Management (SHRM), most organizations decide to outsource work when they need help managing temporary or long-term workforce needs. 

This can be particularly beneficial during busy periods or if a company is experiencing staffing problems—such as those currently plaguing healthcare organizations everywhere. It also allows facilities to focus on patient care delivery rather than on administrative functions. 

By providing a range of services that can help alleviate stress for employees and increase overall productivity at your facility, outsourcing can address specific areas of concern. 

These services may include:

• Billing services  
• Coding 
• Collections and denial management
• Revenue cycle management
• System integration

Outsourcing these administrative functions may be a valuable strategy, enabling your facility to focus on its core operations and maintain patient safety in this tight labor market.

Partner With Coronis Health To Help Maintain Your Facility’s Quality of Care

Coronis is committed to supporting the frontline caregivers who work hard every day, every shift, to keep patients safe. 

Healthy finances lay the foundation for quality care. Our goal is to maximize your profits and reduce your administrative costs so you can continue providing quality care for your patients.

To receive your free financial checkup or to learn more about how we can help your facility in this demanding environment during these stressful times, contact Coronis Health today.

from
https://www.coronishealth.com/blog/affected-by-the-labor-shortage-coronis-can-help/

7 Signs You Need to Outsource

Medical billing is a complex process that requires the focus of skilled, certified billers and coders who are trained in the procedures that facilitate a healthy revenue cycle and prompt reimbursement for a healthcare facility. If you are struggling with timely filing, delays in receiving reimbursement, or staff burnout, you may need to consider outsourcing your medical billing. Here are the signs that may take you one step closer to outsourcing your medical billing and revenue cycle management. 

1. Strains on Your Administrative Staff

Healthcare is a dynamic, challenging industry, and requires a special team of highly trained clinicians and administrative personnel to accomplish many tasks related to patient care. Burnout is not uncommon in healthcare, and if your staff feel overworked or strained to complete their work, you will see a higher rate of turnover and dissatisfaction in your organization. Medical billing is not immune to turnover, as a facility’s focus on revenue-centered results places pressure on billers and coders to push high volumes of claims in shorter time frames, with a high level of accuracy. 

If you are seeing inconsistencies in your revenue cycle, such as issues with your accounts receivable (A/R), timely filing, or an increase in denials, you may have staff who are struggling to keep up with the demands of the work, and may choose to leave your organization. Hiring and training new staff is a costly affair, as you need to find the right fit – someone who is certified and highly trained, and can manage your expectations. Where revenue is concerned, you must set your expectations high, and the demands of your medical billing team will subsequently increase. Keeping a tight-knit billing staff in a facility is tough, so if you are feeling the strain of losing employees due to burnout, it may be time to choose an outsourced medical billing company that focuses solely on medical billing and coding – and nothing else. 

2. Delayed Payments

Healthcare facilities need prompt payment from medical claims to operate effectively, but if claims are not paid in a timely manner, the denied claim workload for your medical billing team increases and creates additional strain. Denied claims are the number one reason for a delay in payments, and could be related to several factors such as overworked staff – which can result in a high rate of billing or coding errors, or having to constantly train new clinicians or staff. 

The decision to outsource medical billing is a step in the right direction; you are choosing to have a group of highly trained professionals to take over your claims review process. By placing your trust in a medical billing company, you are facilitating success as your new medical billing company will ensure a high rate – as much as 99% – of clean claims, which significantly decreases the number of delayed payments. 

3. Decline in Clean Claims Percentage

Clean claims are simple to understand – they are a simple ratio – the average number of claims paid after the first submission. These claims are not stained by the delay of denials or long wait times in A/R, and the percentage should be 95% or higher. If your facility has a clean claims rate lower than 85%, your revenue cycle management strategy is lacking. Imagine 1,000 claims submitted, with only 850 paid after the first submission. This means 150 claims need to be reworked, rebilled, recoded, and resubmitted, which delays payment and could increase the number of days in your A/R as well. 

The percentage of your clean claims rate is a byproduct of the work your staff is completing, so the lower your percentage, the more time your staff is spending on reviewing denials, communicating with payers, and fixing errors before submitting a claim for the second time. 

Denials tell a compelling story about your revenue cycle management strategy. Your clean claims percentage could be telling you to re-write your strategy and outsource your medical billing. 

4. Diminished Revenue

Healthcare facilities have a tough decision regarding medical billing when opening the doors for the first time, as there is little revenue to cover the cost of adding a vendor. If your facility is well established and has a good stream of revenue, it might be time to consider outsourcing your medical billing. There comes a time when the billing process outgrows itself and eventually costs more to keep it in-house. 

The costs of outsourcing your medical billing could possibly equal the costs of keeping it in-house, but the better option is to move forward with outsourcing. An outside revenue cycle management company helps you convert the high, fixed employee costs to a variable expense that can be connected to revenue. Remember, if your revenue diminishes, you still have to pay your staff. Those expenses are fixed and cannot adjust with a loss in revenue.

Compare your revenue with the industry median; if you fall below the industry average, outsourcing could be the key to optimizing your revenue. A robust revenue cycle management strategy is an essential component of operational success for your facility, and ultimately reduces your operating costs.  

5. Struggles Keeping Up with Regulation Changes

The government and other organizations, such as the Centers for Medicare and Medicaid (CMS) dictate the rules and regulations for medical billing. New protocols are constantly introduced by CMS and other third party payers, so it’s critical to ensure that medical billers and coders are consistently updated on changes that affect the billing process. Predicting these changes is not easy, but the changes are inevitable and expected. 

Certified medical billers and coders in an outsourced company focus only on billing and coding, and are constantly updated on new information as it is disseminated by insurance payers and CMS. The information they receive ensures they remain compliant, are up to date on every regulation, and submit accurate, clean claims for your facility. 

6. More Time Spent in A/R

Your facility must understand the many reasons a claim is rejected, but closer attention is required for the number of days a payment is sitting in accounts receivable (A/R), where money due from a claim waits. Medical billers are required to submit claims on time, so a facility should expect that reimbursement would be distributed on time. It’s important to review A/R on a monthly basis to flag payments that are older than 30 days, but the larger your facility, the more difficult it becomes for your in-house medical billing staff to focus on the time spent in A/R. 

An outsourced medical billing company has teams that focus only on denials or A/R. Since they are not tasked with other facility responsibilities, the ability to track and manage A/R becomes less arduous. 

7. Lower Quality of Patient Care

When your staff are overworked and stressed, they will not deliver excellent, quality care to patients. Managing medical billing is complex enough, so adding to the plate with extra tasks such as scheduling appointments and interacting with patients adds to a biller’s workload, and reduces their ability to function at an optimal level. When this happens, a patient’s expectations are not met, quality care is absent, and patient satisfaction rates drop. 

Outsourcing medical billing takes the weight off your team. Let your staff focus on the main purpose of the facility – taking care of the patients, and let the outsourced company do what they know best – medical billing, coding, and managing your revenue cycle process.

Choosing Coronis Health for Your Billing Needs

Coronis Health combines years of expertise with a thirst for providing excellent customer service to ensure that your billing needs are addressed. We provide revenue cycle management services for laboratories and pathologists, behavioral health, hospitals and surgery centers, primary care and specialty physicians, FQHC and CHC services, anesthesia, and emergency medical services.

Additionally, Our team of certified billers and coders are dedicated to providing high quality services so you can focus on your patients. One of the best moves you can make for the revenue health of your facility is to outsource your medical billing or overall revenue cycle management process to Coronis Health. Contact us today for a financial checkup and find out why we are your solution to revenue cycle management. 

from
https://www.coronishealth.com/blog/7-signs-you-need-to-outsource/