The advances in technology have found their way in the health care sector with practitioners looking for better ways of dealing with their ever-growing amount of medical data. Today, many medical practitioners and third-party service providers more than ever before concerned about the safety of their confidential data and the throughput. It is not easy to transmit critical data from one department to another and to ensure maximum collection of revenues from patients for the services provided. Today, healthcare providers are struggling to comply with the HIPAA laws and patient information safety while at the same time ensuring that they minimize revenue losses. This requires efficient medical billing software since such systems are designed to provide for an easy and quick audit of the revenue collection and allocation process.
The ever-evolving nature of healthcare payment system has necessitated that hospitals and other providers of healthcare services design a website and billing processes that can easily accommodate these changes.
The increasing complexity of the medical billing, healthcare insurance claims, and reimbursement has made the entire billing process extremely challenging for medical practitioners. Therefore, medical billing systems are designed to ensure efficiency, interoperability as well as scalability of medical and data capture. Here are some of the best practices that healthcare providers can observe to ensure efficient and increased insurance claims approval.
Billing Systems Should support More Payment Options
The U.S healthcare market is growing very fast and is estimated to hit $5 trillion per year by 2022, the U.S Center for Medicare & Medicaid Services (CMS) said. The other study conducted in 2014 by the Consumers Union revealed that slightly more than 30 % of the revenues earned by healthcare providers end up uncollected or wasted due to lack of efficient collection systems and poor billing and administrative processes. With many payment options coming up every day, healthcare providers must be on the alert to ensure that their system integrates all payment options that may be used by their consumers. Patients who are the consumers of healthcare services have expectations and their needs are ever changing. Billing systems should be designed to include prompt payment of discounts, incentive programs, and smooth referral procedures.
Medical Billing Audits
A proper medical billing audit processes either during a complete cycle or in segments will help to reveal the weaknesses as well as strengths of your billing system. Medical billing and coding are critical aspects in a medical billing audit. Bills that are not well coded will be responsible for revenue losses and can have a significant financial loss in the long run. Similarly, over coded bills means over billing your patients and this is likely to cause more refund claims and at worst subject an organization to a pre-payment review by the healthcare and inspectorate agencies. Over-coding will mean rejection of your claims but you can identify and resolve all these issues through a proper medical audit process.
Ensure Interoperability to Increase Efficiency
It is critical for organizations to transfer or communicate patient health information in an electronic manner in an efficient manner and this requires your system to achieve interoperability. One of the top priorities of most healthcare providers is the interoperability of their HER and data systems since it allows for an easy and seamless integration of various processes involved in medical billing and patient care. Therefore, it is important for organizations to ensure that their billing systems communicate important information in an efficient manner. For example, patient history information may be communicated to insurance providers in an easy and simple way if your medical billing and data information system are seamlessly connected to other providers.
A Focus on Safety of Patient Information
With bulk payments and increasing number of medical billing transactions,
healthcare organizations, as well as patients, are exposed to far too many risks of a data breach. Organizations run the risk of getting into huge financial losses and suffer from a bad reputation because of a data breach. Healthcare sector is certainly one of the most sensitive areas where patient data safety is often compromised. The Healthcare Insurance Portability and Accountability Act (HIPAA) has set out strict rules to enhance patient information safety as well as providing clear guidelines regarding electronic transactions between providers of healthcare and other parties such as insurance carriers. Therefore, healthcare organizations are mandated to use electronic health Records (EHR). To comply with these regulations, healthcare providers have the inevitable option of ensuring they deploy medical billing and coding systems that address patient data security.