Usually, physicians lose their focus and time in dealing with the administrative challenges associated with claim processing and physician medical billing services. Often, the claim rejection rate increases to an alarming level when the physicians don’t streamline their revenue cycle management. Claim rejection has become such a recurring phenomenon that medical organizations wear out their resources and still couldn’t achieve their financial goals.
According to a recent study, it has been revealed that most of the medical facilities deplete 11% of its net revenue due to underpayments each year. While claim processing, payments, billing, and physician revenue cycle management amounts to 14% of the total healthcare expenditure. It is approximately equal to $2.7 trillion in monetary value. Mostly, claim denials happen due to the following two primary reasons;
- The claim isn’t received by the payer.
- The claim has inadequate/incorrect information.
As we have observed that health system operations don’t provide the same leeway today as it did a decade ago. However, if physicians take the right approach and correct strategies then the future doesn’t gloomy.
In this article, I have mentioned 13 key strategies that will enhance profitability for the physician’s practice.
1. Establish Long-lasting Relation with Payers
Physicians must consistently stay in touch with a few private insurance companies in lieu of the government payers. The commercial payors contribute to 35% of the hospital’s net revenue. Thus, if physicians would have an established medical billing processing in place then they would ease out any falls with the payers in the future. Therefore, physicians should collaborate with them in order to understand their work process and create a care delivery model likewise.
2. Adhere to Compliance Standards
One of the most healthcare regulatory standards is the HIPAA act that urges to standardize medical codes to fulfill the protocols of privacy, security, and confidentiality of medical codes. Being a physician, you should make sure that your physician billing services comply with medical coding and billing standards proposed by HIPAA.
3. Utilize Interoperability between Health Systems
Interoperability is one of the most important ways to increase the productivity of a hospital. According to professionals, the healthcare facility has multiple domains and subdomains, therefore, it is essential to ensure that there is proper interconnectivity that can remove the blockades and establish connections between departments and physician medical billing services firm.
4. Use Advanced Methodologies
An outsourced medical billing company can help physicians manage denials, track claims, tax IDs, etc. If physicians would try to keep these aspects in-house then they should hire suitable staff who have hands-on experience in working with HIPAA, Medicare, and Medicaid regulations. Only certified and qualified medical billing professionals can help you avoid denials and rejection. They can help you sustain the financial health of your business in the long run. Most importantly, most of the medical billing firms have robust software applications to accurately proceed with revenue cycle management.
5. Reduce Workload
You can outsource your medical billing to a professional medical billing company to reduce the overheads. You will have a healthy bottom-line as a result of a significant decline in the volumes of claim denials.
6. Leverage Data Analytics
Data analytics can reduce inaccuracies and help you identify the root problems. It would also allow physicians to experience improved transparency and initiate precision medicine, etc. You can start by collecting the historical data of the hospitals and then use statistical, analytical and mathematical tools to drive profitable results.
7. Automate Billing & Coding Process
A physician has to deal with a massive amount of patient care responsibilities. Therefore, they should lessen down their administration burden to save costs and lighten the workload.
8. Focus on Reducing Re-admission
Physicians can identify if a certain group, race, or age have more risks of readmission from data analytics. Thus, they can easily recognize the common issues and focus on getting a robust healthcare plan.
9. Stretch Your Market Value
Physicians can get rid of administrative responsibilities and invest some time and resources to boost the revenue of the hospitals. If at present, you don’t have the bandwidth to dig deeper into the granular level of the physician healthcare revenue cycle management. Then you can outsource physicians’ medical billing services to a reliable medical collection agency.
10. Focus on Revenue Generation Rather Cost Saving
Cost-saving is not the only motive to run a successful medical practice. Physicians should also move towards revenue generation over saving a few dollars. It reduces the cut time to file a claim and successfully allocates the resources. Thus, as the world is getting more globalized, there are more opportunities for physicians to improve their revenue cycle ROI from a centralized connection to multiple locations.
11. Create Population Health Management Programs
Simply, the population health management system helps you deliver best-in-class medical care in the lowest possible amount of money costs. Physicians can manage health management programs to find out the volume of patients. They can easily recognize comparable clinical settings and apply evidence-based interventions and treatment protocols.
12. Well-trained Medical Billing Experts
If you want to maximize your organization’s revenue then you should make sure that only well-trained medical billing experts are taking care of your physician’s medical billing services. A well-trained employee can massively impact the total revenue on investments. A trained employee can also multi-task. They can run your medical billing work efficiently.
13. Collaborate With A Reliable Medical Billing Company
If your business demands more substructures in the future then you should get ready for these services in advance. You should prepare capital investment to own both i.e. human and capital resources in order to keep pace with the rapid industrial development. Despite this, you can also save time and money by outsourcing physician medical billing services to scale up the surging service demands in a cost-effective way.
Physicians can improve their business profitability with the above-mentioned strategies. They should make sure that their medical billing resources are well-versed with federally mandated laws, coding compliance standards, and HIPAA protocols. They should hand over their reimbursement collection to the certified and well-experienced physician billing experts. They should also keep the margin of their capital expenditures from their earned revenue. They can hire a medical billing company to shed away the administration burden from their shoulders.