How to Prevent Write-Offs & Incorrect Account Adjustments?

Healthcare professionals and medical billing services settle payment adjustments on a day-to-day basis. It is their responsibility to maintain data, translate it into an appropriate format, and send it to payers for reimbursements.

The revenue cycle management runs in this flow. But, with incorrect billing and coding practices, finances are forever in jeopardy. Healthcare professionals find themselves between financial complications that restrict revenue for them.

Medical Billing Services Rescue Practices

Managing the billing and coding process is complex and comprises of many regulatory measures. Thus, passing the criteria for each payer whether government or private is technical. It requires experience and the right expertise.

It is also to keep in mind that not all medical practices work in the same manner. Different facilities have different frameworks. The medical billing companies pay attention to detail, to each hospital or medical facility. Having said that, all they want is efficiency and optimization of their revenue cycle!

For Instance, many practices don’t have an established enrollment process. Sometimes, even if they have a clean system in place, uncertainty in account adjustments may occur. If outsourced medical billing services are not good at problem-solving, practices lose quick revenue in the form of write-offs.

How to Keep Track of Account Adjustments?

A medical billing company with dedicated resources for denial management is what’s required. It is not possible to avoid denied claims even if we double-check everything. Yet, if we have no policies or remedies for denied claims, we will always be losing money through these slips.

Such revenue loss does raise questions about performance optimization. Yet, without complete follow up services, you’ll never be able to track what exactly you’re missing.

The Potential Problems

Given below are several potential problems that restrict your growth. For Instance,

· Wrong adjustment codes or write-offs assigned to patients lead to mistakes in ledgers.

· If the medical billing staff has the authority to waive off payments by themselves, there would be an increased risk of fraud.

· The rate of clean claims is lower than expected by the healthcare facility.

Problems Due to Bottlenecks

Another issue with medical billing services is that they don’t watch for bottleneck situations. In such a case, the whole management process can come to a halt. The constant denial of certain claims signify problems in the billing system. Usual problems include the inaccurate use of CPT codes, wrong use of a modifier, and a few others.

The Solution

Internal checks within hospitals and risk analysis via medical billing services simplify. The monitoring system minimizes the risk of fraudulent activities. Such activities may happen during payment postings, refunds, and copayments.

Furthermore, bottlenecks are also preventable. The billing staff should develop a strategy where they keep an eye on outstanding claims of 30, 60, 90, and 120 days.

The more this denial management gets delayed, the more it is likely to stay in files without results. It is thus up to the billing staff to push any denied claim from stacks to upfront.

You have to pay more attention to why it takes so long for a claim to get paid. A proper investigation into the matter can give you answers.

What Should Billing Staff Do?

Healthcare practices do not want to hear at the end of the day that certain claims did not get paid. Besides, as a medical billing outsourcing company, we must know why a claim didn’t pass.

Not getting reimbursed for rendered services demotivates the medical practitioners. It also creates hurdles for healthcare practitioners to provide quality care to patients.

An expert medical billing and coding team caters to a working RCM process. It understands the complexity of the system better than an in-house team. Thus, they are able to avoid complications.

If you’re facing such problems in your revenue cycle, it is better to consult an outsourcing billing service such as P3Care. We get your issues fixed under expert supervision. Besides, we work on denied claims and create clean claims more often than not. No more unauthorized account adjustments. Hence, our professionalism, transparency, and management bring a ton of revenue benefits to you.