As a successful medical practitioner, If you want your medical practice to keep growing, you need to identify any problems that are preventing that growth and address those issues. That’s what a medical billing assessment is for.
What Is a Medical Billing Assessment?
A medical billing assessment includes a comprehensive audit that focuses on:
- Analyzing your practice’s billing performance
- Auditing its policies and procedures
- Assessing the technology and tools you use
- Reviewing your patient care workflow
Often, physicians will unintentionally under code or over code for patient services performed, or simply don’t document well, which can have a negative impact on your practice’s bottom line.
Frequency of a Medical Billing Assessment
⇒ Industry experts recommend that every medical practice have a billing assessment conducted at least once a year or more often such as a semiannual audit of all providers who bill for services.
⇒ It’s also a good idea to have an ad-hoc assessment if you have any concerns about coding patterns or your practice has a history of shoddy documentation, or if you have recently added a new physician to your practice. A surprising assessment is a good idea so employees can’t try to plan ahead for the audit by falsifying or hiding documentation.
⇒ Assessments are key, providing a tool to evaluate things we are doing well and things we could do better.
But how do you know that your practice could use an assessment, especially if it includes the state of your medical billing apparatus?
How do you know if it is time for a medical billing assessment?
Here are some tips that it may be time to enlist the help of a financial health diagnostic specialist to evaluate the overall financial and workflow health of your practice.
Is your practice growing?
- Many practices enjoy growth and expansion; others prefer to stay small and can sometimes be forced to turn new patients away. But what if your practice is stagnant? Chances are it has nothing to do with the medical care you are providing, but more so how the patient is made to feel with regard to their interactions with your practice.
- If patients are feeling disenfranchised because they are having issues in rectifying their insurance with your revenue system, or they are experiencing inconsistent billing, the odds are likely that the patient will go elsewhere.
- Sadly, most people don’t have time to navigate a complex system like medical billing and will opt to go where a practice understands the nuances of customer service and proper billing and collections.
- Because it is either their own insurance or personal finances that have to work seamlessly with whatever medical practice they choose.
What is the Status of Payer Contracting?
Insurance plans are constantly changing and evolving.
Is your practice able to keep up?
Can it differentiate between extended coverage vs. federal minimum requirements?
Do you understand Tricare, VA medical, Medicare, and Medicaid?
If your practice’s understanding of contracts is not in synch with the insurance companies you accept and the services you provide, then an assessment may be in order to pinpoint areas of failure and resolve them.
Is your practice up to date with Medicare?
Does your staff know that Medicare fee schedules are updated annually?
When they are, you can expect a lot of changes that can affect reimbursement values. Revised fees can add hundreds even thousands of dollars to your reimbursement costs.
Medicare is instituting a new ID card to better protect patients’ personal data. The roll-out is underway now nationwide and will cease on December 31, 2019.
Is your practice ready to convert to the new system?
Has training occurred?
If your practice is not up to date on Medicare, then consider an assessment to bring your practice up to speed.
How do you handle denial management?
Statistics show that 20-30% of claims are rejected and 80% of those rejected claims go unprocessed. Denied claims to reduce or delay incoming revenue and that impact patients’ trust and confidence. A financial health diagnostic specialist will help you determine the gaps and flaws in your denial management system and will advise ways that can maximize revenue recoupment.
Is it time for a second opinion?
If you have any of these concerns, We can help you achieve greater profitability while at the same time freeing up your time to focus on patients. Our innovative and dynamic medical billing services will help you to achieve a high level of effectiveness that will result in the enhancement of overall practice management.
Is it time for a medical billing or comprehensive operational audit and practice evaluation? If so, Outsource your insurance medical billing duties with our professional billing staff, and your days of insurance company stress can be over for good! We will take on all tedious responsibilities that come with medical insurance billing so you can focus all your energy on what really matters: your patients.
Contact us for a complimentary practice Analysis and billing assessment consultation.