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Back to the blogAug 28, 2021

7 Medical Billing Best Practices

7 Medical Billing Best Practices

Your practice cannot serve patients well without a robust revenue cycle. A strong medical billing process will keep your practice financially healthy and let you focus on your mission – improving your patients’ health. Here are seven medical billing best practices to get you started.

Medical Billing Best Practices 1: Use an Integrated EHR and EPM System

Integrated EHR and EPM systems like NextGen Healthcare save you time and money on medical billing. These systems draw patient information, coding, and documentation from your EHR and help you process it for claims submission. You can also automate billing processes to reduce errors and speed up reimbursement.

An integrated EHR and EPM system reduces the need for manual data entry. This eases medical billing burdens and helps reduce claims denials because of simple errors. You can also use your system to keep patient information, like insurance coverage, up to date. In one integrated system, you can schedule appointments, update patient information, document an office visit, and bill payers.

Medical Billing Best Practices 2: Build the Right Team

Medical billing specialists, front desk staff, and providers are critical parts of your practice’s financial success. Look for medical billing specialists with experience in your practice management system. These skilled professionals can help your practice maximize reimbursement. Experienced medical billing specialists can also help you improve workflows to reduce claims denials and late payments.

A strong front desk team can also help keep your revenue cycle on track. Front desk staff accurately collecting patient demographics and insurance information is critical in preventing denied claims. They can also assist patients in updating their insurance and other information to prevent denied claims. Collecting co-payments, deductibles, and co-insurance upfront help you to reduce post-visit patient billing and large patient balances in accounts receivable.

Providers also play an important role in revenue cycle management. Not only do they generate revenue by seeing patients, but they can also help maximize your reimbursement with appropriate coding and documentation. Providers who have deep experience with EHRs can code and document encounters during the visit, saving time and improving charge lag. If your providers struggle to effectively use your EHR and EPM system, targeted training can improve satisfaction and reduce the potential for physician burnout.

Medical Billing Best Practices 3: Make It Easy for Patients to Pay

Patient deductibles, coinsurance, and copays can be a significant source of delinquent payments. You can reduce your accounts receivable time by making it easier for patients to pay. Paper bills can get lost in the mail. Surveys show that patients want flexible payment options like online payments and prepaid cost-sharing. Tools like NextGen’s Patient Portal, formerly Medfusion, can let patients pay their bills online at their convenience. Patients can even pre-pay their cost-sharing before they arrive for their visit. The latest NextGen upgrade also includes a cost estimator tool to help patients know the cost prior to their visit and practices can better collect at the visit.

Medical Billing Best Practices 4: Submit Electronic Claims to Payers in a Timely Fashion

With over 85 percent of practices using EHRs, most patient records are now electronic and charges are automatically generated and sent to a practice management system. Submitting claims to payers in a timely fashion has never been easier. Integrated EHR charges directly into practice management systems to generate claims also reduces data entry errors and claims denials by pulling data directly from your provider.

One common reason for claims denial is late claim submission. You can help your practice stay on top of medical billing by automating simple billing processes. Using your integrated EHR and EPM, you can auto-generate claims from patient encounters once you have a robust claim edit library configured to ensure inaccurate claims are not created. This helps ensure a consistent, manageable workload for your medical billing specialists so they can submit all claims timely. More automated processes also free your staff to focus on working complicated claims, resubmitting denied claims, and resolving delinquent payments.

Medical Billing Best Practices 5: Keep Track of Your Revenue Cycle

Your EHR and EPM hold more than patient records. It also contains key data on your practice’s finances. With an integrated EHR and EPM, you can keep track of accounts receivable, denied claims, and bad debt by the payer. For NextGen users, TempDev developed Revenue Cycle Dashboard NextGen EPM Report to show key revenue cycle metrics in one place. In one report, you can track payments, adjustments, denied claims and accounts receivable by days since billing. And all data can be aggregated by the payer and financial class, letting your practice identify problems and fix them.

Medical Billing Best Practices 6: Resubmit Denied Claims

Even with strong medical billing processes, claims denials happen. By one estimate, up to 50 percent of denied claims are never reworked. If your practice is not resubmitting denied claims, you are leaving significant revenue on the table. Your medical billing specialist should follow up on all denied claims to attempt to resolve the problem. Many claims are denied because of simple errors or omissions. Building time for claim resubmission in your medical billing processes will ensure that your practice receives all of the reimbursements you are entitled to.

Medical Billing Best Practices 7: Develop a Culture of Continuous Improvement

All practices have room for process improvement. Your practice can build in feedback loops to help identify bottlenecks and resolve them in the regular course of business. Tools like dashboards and reports can help you keep track of your clinical, administrative, and financial progress and identify problems before they become entrenched. You can also develop a culture of continuous improvement by encouraging staff to report problems and propose solutions.

Medical billing processes need to change over time as technology and payer expectations change. A culture of flexibility and continuous improvement will serve your practice well under frequent changes to the health care system.

How TempDev Can Help with Medical Billing Best Practices

TempDev’s revenue cycle consultants can help improve your NextGen EPM billing practices. If your practice is facing revenue cycle problems or has fallen behind on medical billing, TempDev can help. TempDev’s biller staff augmentation services can also help you cover key staff absences or catch up on billing.

Call us at 888.TEMP.DEV or contact us here for help to implement medical billing best practices with Team TempDev.


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