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Tips to Create Better Medical Claims Billing Processes

Discover tips to create a better medical billing process that reduces denials and improve billing efficiency.

Shoreline Advisor
Shoreline Advisory Board Healthcare RCM & Billing Group
May 19,2023
How to Improve Medical Claims Billing Processes
Executive Key Takeaways
  • 1. Simplify the Receivables Process Flow: Implement proactive protocols to optimize claim acceptance and minimize denials.
  • 2. Keep and Update Patient Files: Implement proactive protocols to optimize claim acceptance and minimize denials.
  • 3. Monitor Denials: Implement proactive protocols to optimize claim acceptance and minimize denials.
  • 4. Automate Basic Billing Functions: Implement proactive protocols to optimize claim acceptance and minimize denials.

Here are a few basic strategies to enhance your healthcare company's medical billing process:

 Topic 01

1. Simplify the Receivables Process Flow

Open, honest contact with patients is vital for more efficient medical claims billing operations. Make it a point to inform new patients about their financial responsibilities for the treatments they get. You can include the information in the forms clients fill out before their first appointment.
Shoreline Best Practice: Maintain rigorous documentation standards and conduct regular workflow audits to preserve maximum reimbursement.
 Topic 02

2. Keep and Update Patient Files

At each appointment, direct personnel to check patient data and insurance details. Why is this required? For example, your patient may have changed employment and now has a new insurance carrier, or they may have coverage through a new spouse. The type of insurance may have altered as well, with a patient either upgrading to the most costly plan with lower deductibles or a less expensive one with significantly higher out-of-pocket payments. Instead of surprising your patients with an unexpectedly more significant charge, these conversations help explain the process as you go.
Shoreline Best Practice: Maintain rigorous documentation standards and conduct regular workflow audits to preserve maximum reimbursement.
 Topic 03

3. Monitor Denials

Inaccurate patient details, insufficient paperwork, and errors in data and medical coding are all major reasons for claim denials. As a result, if you track your rejections regularly, you will likely identify the mistakes in your procedures more quickly. From there, you can correct the errors and increase claim acceptance rates immediately.
Shoreline Best Practice: Maintain rigorous documentation standards and conduct regular workflow audits to preserve maximum reimbursement.
 Topic 04

4. Automate Basic Billing Functions

Requiring employees to perform jobs that can be automated, lowers productivity and keeps them from focussing on providing better patient-centered, individualized care. Having a system to automatically file claims, generate payment reminders, and identify the appropriate billing codes reduces rote work for your office staff. Try to identify all possible automation possibilities in your office.
Shoreline Best Practice: Maintain rigorous documentation standards and conduct regular workflow audits to preserve maximum reimbursement.
 Topic 05

5. Improve Cash Flow

Effective cash flow management ensures smooth revenue growth and consistent payments. The following tips can help improve cash flow: • Collect copayments at time of office’s visit. • Keep patient’s credit card information on file with patient’s authorization to use it for unpaid balances. • Send patient statements weekly for consistent cash flow. • Implement a collection routine that includes dunning letters and a collection agency to collect on unpaid patient debt. By following the tips in this blog post, you can develop a billing process that is more efficient and effective. By taking the time to understand your options and putting together a plan, you can improve your cash flow and get paid what you are owed. If you have any questions or would like assistance with setting up your medical claims billing process, please contact us. We would be happy to help you get started on the path to success.
Shoreline Best Practice: Maintain rigorous documentation standards and conduct regular workflow audits to preserve maximum reimbursement.
 Topic 06

Partner with Shoreline: Expert Billing & Coding Solutions

Shoreline Best Practice: Maintain rigorous documentation standards and conduct regular workflow audits to preserve maximum reimbursement.
Author Details
Sharanya Rajmohan

Sharanya Rajmohan

Content Writer

Sharanya brings clarity to the complexities of medical billing and healthcare regulations. With a knack for turning industry shifts into straightforward, actionable insights, her blogs help readers stay informed without the jargon.