Effective Strategies to Optimize Surgery Billing Processes

Private healthcare providers know that if they don't get enough cash flowing into the revenue stream, they cannot continue to provide proper care and keep their practices afloat. As much as we’d wish health care to be less about money but more about people getting the help they need, many private healthcare practices need to optimize every avenue to succeed, especially surgeons.

In most cases, clinical and surgery billing information is kept separate, making it hard to integrate the various departments that patients go through. One departments’ inefficiency can affect the integrity of the revenue cycle. Surgeons and related healthcare providers can lose between 3 and 5 percent on their revenue if there are no tight controls.

While there are many services, techniques, and software available to help with surgery billing and revenue cycle management, there are three primary areas that healthcare providers can address and optimize for better financial health.

1. Patient Access

A large portion of a patient’s claim form is generated at the first consultation. This is where as much information that a patient can give is collected, it is also a point where the healthcare provider gets to contact the medical insurance company.

 It is important to have a good software program and a seamless link to the network of insurance companies to obtain approvals for certain procedures and avoid denials of payment later on when the patient has received the treatment and care. It is also important for healthcare providers to have clear guidelines about collecting and validating patient information.

2. Insurance Validation

Issues experienced with insurance verification or pre-authorization in the admission process are caused by failure to wait the prescribed 12 to 24 hour waiting process that is commonly required to get healthcare insurance company claims verified especially in cases of emergency.

It becomes important for facilities to require some kind of up-front cash payment, which payments can claim back from their insurer if the procedure ends up being approved. Patients need to be made aware that they might have to pay upfront upon admission and they would need to be appraised of what they are being billed for if they stay for an extended period in the hospital.

It might sound tedious but it helps the patient and the healthcare provider to keep tabs on the costs of treatment. It always helps to know what insurers normally pay for and what they don’t. There are systems and programs that can be used to automatically notify both the healthcare provider, the healthcare insurer and the patient.

3. Charge Capture

For surgeons and healthcare providers to improve the charge processes they need to test the completeness and accuracy of the charging process. Caregivers can use a method to identify lost charges and finding where the revenue leakage is. There are IT tools that can help identify missed charges effectively and more efficiently. With such tools, surgeons can avoid complications with surgery billing.

4. Surgery Billing & Payment Accuracy

The processes involved in billing, collections and payment management are the key processes for revenue optimization. To maintain a healthy bottom line it is important to identify payment inaccuracies this involves improvements in technological processes that makes timely resolution of billing issues.

The correct tracking methods can help in the monitoring, classification and resolution of payment issues. Surgeons and medical staff who have the tools to identify, understand and quantify the root causes of bad debts are an a better position to avoid and actually see the opportunities that exist more effectively.

As much as we’d like to escape the truth, the fact is healthcare is a business and it is important for healthcare providers to keep their revenue collection strategies in tact. The industry has been known to be unstable when coming to keeping their revenue integrity.

Actionable FQHC Billing Resources Worth Bookmarking

If you have stumbled upon this article, then you're probably well aware that quality, relevant, and actionable FQHC billing resources are few and far between. In fact, such medical billing resources for FQHCs (Federally Qualified Health Centers) are quite new and emerging to the medical billing and coding community throughout the U.S.

For this reason, we have researched some of the best resources available to help FQHCs improve their medical billing processes. If you operate a FQHC or similar community medical practice or health center, then you may want to bookmark some of these great FQHC billing and coding resources for later reference.

Custom FQHC Billing Consulting Services from Practice Management

Practice Management is perhaps one of the most reputable and leading medical billing firms that specializes in FQHC billing solutions. In addition to providing comprehensive medical billing and coding services for FQHCs, Practice Management also offers individualized, custom-tailored consulting programs that focus on the in's and out's of FQHC medical billing. The company boasts an impressive display of resources and systems that can be easily integrated into any FQHC billing process. To learn more, visit MaximizedRevenue.com, or visit the firm's FQHC billing services and solutions page by clicking here

The Complete FQHC Billing Guide by iFinance

The FQHC Billing Guide by iFanance provides an accurate account of the procedures for medical coding and billing, as well as information regarding collection of payments, past due payments, and how to handle denials and returned claims. It is pleasantly presented in pdf format for easy printing or searching the document on the computer.

Centers for Medicare and Medicaid (CMS.gov) on FQHC Billing

This FQHC billing resource provides an accurate breakdown of the dates and payment systems that have been predetermined by the Centers for Medicare and Medicaid Services. You can use this link to provide a well-researched outline of how to implement your training to meet deadlines for the transition between ICD-9 and ICD-10 CM. They also provide a wealth of links and PDFs that will be handy when you are various manuals that will help you along the way. To learn more, visit CMS.gov.

FQHC Billing and Coverage from CPCA.org

This PDF provides a wealth of information regarding the various changes to codes you can expect from an ICD-10 program. You can easily reference this PowerPoint at any time during your training and it will be a great resource medical coding and billing specialists when studying for the change between systems.

Learn more and delve into this valuable FQHC billing resources by clicking here.

FQHC Billing IT Toolbox from HRSA.gov

This resource offers a variety of free resources that will be helpful in making the upcoming billing and coding transition, as well as the various methods of processing claims for various office situations. It helps to serve hospital, doctor’s office and clinic staff in making the transition. To checkout the medical billing IT toolkit, click here.

FQHC Billing Training by Synergy Billing Academy

FQHC Billing and Training by Synergy Billing Academy provides in-depth training in the transition between ICD-9-CM Coding and ICD-10-CM Coding. This training is extremely beneficial and affordable for almost any medical office setting. The change between ICD-9 and ICD-10 are dramatic and can if training is overlooked it can easily cause offices extreme financial distress when the transition is complete. It is important to ensure that all medical coding and billing staff is well versed in ICD-10 procedures before it is implemented.

Why Invest in FQHC Billing Resources

There are many reasons to ensure that these resources are part of your training procedures when it comes to ICD-10. They are extremely effective in preparing the staff for the necessary transitions as well as providing the training necessary to ensure that the deadlines are met for the upcoming transition in medical coding and billing programs.

The transition to ICD-10 is going to be a drastic change for all personnel, and insurance regulations will be changing right along with it. In order to ensure that a medical office is not financially vulnerable, you must ensure that your staff is ready for the change and the best method of doing so is to ensure that they are provided with the proper information.

5 Patient Billing Tips to Improve Your Medical Practice's Cash Flow

When it comes to improving your medical practice’s cash flow, there are plenty of vital aspects that need to be taken into consideration. For a medical practice to be financially successful, it is crucial to implement sound medical billing and collection procedures.

Whether you're embracing the complexities of pediatric billing or dialing in your health center billing strategy, the following tips will certainly help reduce your receivables, thereby saving you time and making your job easier. Here are some unique patient/medical billing tips to help improve your practice's cash flow.

Be Informative Regarding Payment Policies

It’s important to let the patients know about the new payment policy, so that they are aware of what to expect before the first appointment. Considering the fact that medical offices are busy places, this can’t always be followed on consistent basis, but it should be strived for. Also, owing to the complexities of insurance plans, patients may not be aware of the deductibles and co-payments and they tend to assign this responsibility to the practice.

The practice will likely make the best effort to identify the benefits, but patients should understand that they are eventually responsible for any balance that is not paid by the insurance company. So any good medical billing practice, this should be made clear to the patient both verbally and in writing.

Acquire Sufficient Patient Information from the Start

Getting complete demographic and insurance information is crucial for improving the efficiency of medical billing and collection procedures. It is the duty of the receptionist to ensure that new patient demographic forms are complete in all respects.

As patients tend to be rushed, they often leave out critical information. By checking forms for completeness relieves you from having to make calls to the patient later on. This is perhaps one of the most often overlooked medical billing tips that's very easy to implement effectively.

Get Patients' SSN

Another patient billing tip is to make sure to obtain the patient’s social security number. Patients are often reluctant in giving out their social security number for security reasons. But, you need to educate the patient that a number of insurance companies still utilize SSN as a way of identification.

You should also explain to the patient that a social security number will speed up the processing of the claim. Moreover, it is easier to go after an unpaid patient when you have their social security number. We give credit to FQHC billing company - Practice Management for that tip, as they offer a wealth of expertise and professional insight on all things medical billing, spanning from OB/GYN billing to pediatric billing.

Assess Patients' Eligibility & Benefits

Always ensure to check your patient's eligibility and benefits. There is medical billing software that offers insurance eligibility verification. While this technology may not be ideal, it can save you considerable amount of time. You can use insurance company websites that are available to check eligibility and benefits. It is easier said than done in a busy practice, but you need to do it selectively.

Establish Patient Agreements

Get patients to sign an agreement that allows you to leave voice messages at the phone number concerning account billing matters. If there is no such agreement in place, the staff is not legally permitted to leave specific billing and collection information on a voice mail. If the account of a patient is overdue, you have a better chance of collecting your fees if you are able to leave a message requiring immediate payment, or the account will be turned over to the collection agency.

With that being said, implementing these procedures will help you reduce your collections volume and improve your practice's cash flow. The idea is to save time and money, which will eventually improve your overall billing and collection practices. As an alternative to optimizing your practices internal billing processes, you can also recruit the help of medical billing agencies to provide their resources and expertise.

Medical Billing Agency Now Offers Specialized Services for Cardiologists

Practice Management is pleased to announce that it now offers specialized cardiology billing services for cardiologists and related medical professionals. Finally, a medical billing service that specifically-tailored to the complex billing challenges of cardiologists and cardiology centers alike.

From the east coast to the west coast, cardiologists can now take advantage of an easy to use billing solution that keeps an accurate account of patient billings in a way that makes it easy for both the client and the provider to keep better organized. With the help of Practice Management, cardiologists will be able to rest assured that their medical billing is being submitted and saved properly in a way that is law abiding under Federal, State and Local government rules and regulations.

Technology-Driven Cardiology Billing Solutions

Put the Practice Management group of cardiology billing specialists together with the best technology available and you have a cardiology billing service that is leading the charge as the best way to keep tabs on medical procedures and helping patients receive proper reimbursement on claims that are submitted. Practice Management is the new wave of medical building and creating a new way that cardiologists do business. They among the few companies capable of bringing you unprecedented results for all of your medical billing needs.

With electronic access to billing through data transmission, web portal access, telephone and video conferencing, Practice Management is able to not only communicate but provide constant contact with you and your operation throughout the process. Being able to access your office’s data allows us to provide you with billing information all while you continue with bringing your customers the absolute best treatment available. In short, Practice Management strives to help you so can you help them. The goal of the company is to help you be a better physician and focus less on the paper work that goes on with cardiology billing.

Comprehensive Medical Billing Expertise

For Practice Management, the company's goal is to provide a wide range of physicians with a variety of medical billing solutions for a wide variety of practices. Along with that, experts of the company help practices be more efficient and work more with their patients and less on paperwork. They have a great deal of expertise giving our billing services to a wide scope of health and medical practices, including: allergy based practices, cardiology based practices, cardiovascular and thoracic surgery practices, CHC practices, dermatology practices, DME practices, electrophysiology practices, ENT practices, family practices, FQHCs, gastroenterology practices, geriatric practices, health center practices, hospitalist practices, internal medicine practices, nephrology practices, neurology practices, neurosurgery practices, OBGYN practices, orthopedic practices, pain management practices, pediatric practices, podiatry practices, primary care practices, sleep study practices, surgery practices, urology practices, vascular surgery practices, and more.

The goal of Practice Management is to continue to expand into even more medical practices. The company knows that with proper technology, their team of specialists can help develop a better way to keep track of medical bills and keep physicians with their patients and not worrying about paperwork and billing. With the medical billing technology of Practice Management, the company believes it can make an impact in both the lives of medical experts and doctors as well as the people that they serve on a daily basis in their respective places of business.