Your medical practice relies on smooth, accurate medical billing to receive payments for your services. But if you’re like many medical practices, there may be some room for improvement within your medical billing process.
Nailing down a reliable medical billing procedure can save you time and help you collect payments from insurance companies and patients faster, improving your revenue stream. Read on for ten best practices in medical billing to streamline your process.
1. Accurately Document Patient Information
Incorrect patient information is one of the main sources of medical billing errors. When medical bills contain errors, insurance companies are much more likely to reject them, prolonging the billing process. Claim denials can add several weeks to the process, causing your healthcare organization to lose access to necessary funds in the meantime.
Because having accurate patient information is so important, you should verify this information regularly. Every appointment (or every few appointments), ask patients to review and correct the following information:
- Date of birth
- Insurance ID number
- Phone number
The easiest way to verify this information without wasting time in your medical practice is to send patients digital forms they can complete before their appointments.
Using Weave Digital Forms, you can easily collect patient information and automatically integrate it into your practice management software. Weave lets you create custom forms with drag-and-drop functionality and built-in section templates to get you started. You can also upload any paper forms you already use, and Weave will digitize them for you.
Incorporating digital forms into your medical billing can save your practice effort, keep appointments on schedule, and ensure that errors in patient information don’t slow down your billing process.
2. Verify Patient Insurance Eligibility
Tracking down a patient’s insurance company and researching their coverage is a time-consuming process, but it’s necessary to ensure that you bill the right companies. You should be verifying your patients’ insurance eligibility with every visit to prevent claim denials. Patients may change or lose insurance coverage between appointments without notifying your team.
Understand that patient insurance eligibility is different from insurance verification — both are important steps. Eligibility is a patient’s opportunity to receive coverage from their insurance provider for your medical services. Verifying the patient’s enrollment status and whether or not you are a covered healthcare provider should be your first step in the medical billing process.
Then, you can dig deeper to verify that your medical service is a covered benefit under the patient’s insurance policy.
You can verify a patient’s insurance coverage through a few means:
- On the insurance company’s website
- Through a clearinghouse
- Through Weave’s insurance verification software
For instance, Weave Insurance Verification is a user-friendly verification tool for dental practices that automatically verifies patient insurance. Incorporating this medical billing service into your practice can save you a significant amount of time.
3. Code Correctly
Medical billing best practices include enhancing your medical coding service. Medical coding can be a complicated process, but getting it right is essential to your cash flow. Two of the most common medical coding errors include:
- Undercoding: Replacing medical codes with ones for less expensive procedures
- Upcoding: Replacing medical codes with ones for more expensive procedures
Both of these errors can lead to rejected claims and delays in receiving patient payments.
Aside from undercoding and upcoding, errors within service documentation can lead your medical coding staff to incorrectly code services. For instance, the healthcare provider may have described the service too vaguely, leading a medical coder to guess about the nature of the service.
Follow these tips to avoid medical coding errors:
- Double-check all medical codes before submitting a claim
- Ensure that all patient information is accurate and aligns with coding data
- Avoid duplicate billing
- Communicate with the provider if you have any questions about a medical service
4. Submit Claims in a Timely Manner
The faster you submit a claim to the insurer, the faster you will receive reimbursement for your medical services. Get into the habit of submitting claims as quickly as possible to avoid delays. Doing so can also give you more time to handle a rejected claim without impacting revenue too severely.
Many insurance companies require claim submissions within 95 days (or fewer) of the appointment. Failing to submit claims within this window can lead the insurer to deny the claim, prolonging your process even more.
The best way to get into the habit of submitting claims in a timely manner is to develop a routine process that all billing staff in your practice follow. This process may look something like:
- You code the medical service within 24 hours of the appointment.
- You submit the claim within a week of the appointment.
- You assign at least one medical biller to double-check that all claims from a week prior have been submitted by the end of each day.
- Delayed claims take priority the following day.
5. Use Technology to Streamline the Process
Submitting claims to insurance companies is only half the battle in medical billing. You also need to collect patient payments for the amount their insurer does not cover.
Chasing down accounts receivable can take months or even years in some cases. Patients may fail to pay medical bills for many reasons:
- They can’t afford to pay the bill by the deadline.
- They’re unsure what they owe versus what the insurer will cover.
- They’re unsure when the payment is due.
- They’re unsure how to make a payment.
- They forgot to make the payment.
Using a payment automation solution can mitigate many of these issues. For instance, with Weave Payments, patients can pay their medical bills through several convenient methods:
- Text to pay
- Short links
- Tap, dip, or swipe to pay
- Automatic payments from a card on file
- Manual card number input
- Buy-Now, Pay-over-time
Making payments more convenient can remove barriers and encourage prompt resolution of your accounts receivable.
83% of practices that switch to Weave start collecting payments faster
Collect more with less time, effort, and hassle. and let your customers pay the way they want, whether they’re in the office or miles away.Schedule Demo
6. Monitor Payment Trends
Using the best medical billing practices involves staying up to date on patient payment trends. This practice goes along with the previous one — making payments as convenient as possible.
In 2023, patient payment trends include:
- A rising need for digital payment solutions
- Storing digital payment methods on file
- Increasing price transparency, especially for patients without health insurance
- Using value-based payments instead of fee-for-service payments
- Implementing AI healthcare payment processing
- Providing consumer-like healthcare experiences
Your medical practice should stay current with emerging payment trends to ensure that you provide the payment experience your patients expect.
7. Stay Compliant With Regulations
Medical billing regulations are always changing, but you must ensure your medical practice’s ongoing compliance with these regulations. Failing to follow medical billing rules can lead to rejected claims and hurt your cash flow.
For instance, many healthcare organizations are still adjusting to the Surprise Billing law implemented in 2021. This law protects patients against surprise medical bills by requiring good-faith estimates of medical services for self-paying individuals and establishing denial management processes for providers.
8. Provide Patient Education
A major survey conducted by West Health and Gallup found that 94% of Americans believe healthcare services cost more than they should. When the majority of patients walk into appointments with this mindset, their likelihood of making prompt, full payments drops.
One way to counter this negative mindset is through patient education. When patients understand why a service is important, they may view the billing process more positively.
Educate patients on:
- The consequences of neglecting patient care
- Statistics about the success of their treatments
- How they can minimize the need for future healthcare by taking steps now
- The average out-of-pocket costs for specific services
Taking these measures can aid your healthcare revenue cycle management, but it can also lead to better patient engagement, which helps your practice overall.
9. Train Staff on Billing Best Practices
Your medical billing staff should receive in-depth, ongoing training about medical billing best practices. Take the time to train your staff on:
- Coding services
- Revenue cycle management
- Submitting clean claims
- Utilizing medical billing software
- Confirming prior authorization for services
- Managing accounts receivable and following up on unpaid bills
10. Follow Up On Unpaid Claims
Nearly one in 10 adults owe more than $250 in medical debt. While you can’t force a patient to make payments, you can take a few measures to encourage patients to follow through on unpaid claims. Use these medical billing best practices to follow up on unpaid bills:
- Send the payer weekly reminders of their balances to keep them at the top of their minds.
- Provide clear instructions for how the payer can make payments.
- Simplify the payment process.
- Offer financing solutions to make bills more manageable for the payer.
The best practice you can implement right now is incorporating Weave Text to Pay into your revenue cycle management process. Did you know 30% of patients want to pay bills with a text? With Weave Text to Pay, patients can pay their bills with a quick text message, eliminating barriers and encouraging prompt payments.
Large and small practices alike use Weave to simplify medical billing and other routine processes, avoiding the need for an expensive medical billing company. Request your free Weave demo today.