4 Key Medical Billing Steps to Boost Practice Revenue

The medical billing process comprises a set of steps that are clearly defined to ensure a smooth and efficient workflow and maximum financial performance. The steps vary from registration for patients through insurance verification to claim submission and follow-up payment. Any slight inefficiency or omission within any of these steps could result in delays to payment, denial of claims, and increased costs, as well as penalties, fines, and legal problems. Medical billing outsourcing is the best option for resolving healthcare providers’ many complex problems and issues.

Efficient medical billing is one of the most effective ways to increase medical practice revenue. By streamlining key steps such as accurate charge capture, timely claims submission, and proactive denial management, healthcare providers can minimize revenue leakage and ensure faster reimbursements.

This article will outline the four essential steps to ensure your billing process flourishes and you have a constant income. These are the tactics that skilled billers and coders who provide medical billing services should use:

Medical Billing System: Ensure Effectiveness and Maximize Revenue

Patient Data Collection

The initial step is the gathering of basic demographic data about patients. The accurate and complete information collected in this phase will be the basis for following medical billing procedures. Your front-end team is accountable for obtaining the most current information available:

Name

Age

Address

Contact number

The motive for the visit

Medical background

Medical diagnosis

Treatment plans

Records of medication

Name of the insurance payer

Policy number

Allergies

The accuracy of collecting the above data is vital to ensure the safety of your patients. It also ensures correct claim submission and an overall efficient billing process.

Insurance Verification

After registering, your next task is to confirm the insurance details and eligibility before the visit. This is essential to determine the benefits patients can expect from the medical services you propose to offer. Insurance coverages differ from company to company, and information can be updated at any time. 

Therefore, a regular check is required to confirm if services that will be provided at the time of the visit are covered. If a new appointment involves paying a cost for the patients, they must be aware of this before the visit to avoid complications later. It is possible to verify insurance through these methods:

• Directly contacting insurance companies via telephone

• Online Checking

Automating this process with specially designed software can reduce the burden of manual work, reduce human errors and claim denials, and eventually get you timely payment for your service.

Create Super Bills

After the patient leaves the medical facility, the summary of all updated information, medical records, and the services provided to the patient during the visit to one document is known as”super bill. It’s a complete list of vital information required for payers to be reimbursed for the services provided. A single or minor mistake could lead to the denial of a claim.

A medical coder carries this out. It includes data like:

• Clinical and provider information

• Patient contact information

• Patient’s demographic

• The medical history of the patient

• Services and procedures information

• Codes for CPT as well as ICD-10

• Dates of service

• Applicable diagnosis

• The amount for each service and the total cost

Charge Capture

The charge-capture process involves recording all services provided and entering all healthcare expenses into the bill-payer system. Medical billers verify all medical information and corresponding medical codes so that the correct value is given for the services you provide. The invoice is utilized to make claims.

If you don’t, consider implementing electronic health records (EHR) systems to ensure precise data entry and reduce the chance of mistakes.

Bottom Line

The final step, medical billing, is a crucial factor that directly affects your clinic’s profitability. Outsourcing medical billing isn’t only an option but rather a necessity to meet the current challenges in the healthcare system.