If right now you outsource your revenue cycle management, you realize that the performance of your medical billing service provider is central to your medical practice’s financial success. Repayment keeps on declining, and the movement towards value-based will keep on jeopardizing your medical revenues if your medical billing company is not working as expected.
Billing services are the best medical billing solution available in the medical industry. But evaluating those billing companies is a vital aspect for better billing services.
So what does it take to get the best performance and how would you know whether you are getting it or not? Is it true that you gathering every dollar that you can (from the patient and the payers)? One of the most significant issues with a private medical facility is the absence of comparison data. What should your yield-per methodology be? When you are contrasting your practice repayment rates with different groups, would you say you are comparing one type with a similar organization? What about days in AR—how rapidly would it be advisable for you to get your cash?
Comprehensive assessment of the 5 basic revenue cycle KPIs beneath will enable you to gather data about your present medical billing service provider.
- Charge Capture
You can’t measure what you can’t tally. A charge capture audit (done accurately) is a manual procedure however one that will be worth your time. Return 120 days from the present date and look at log of patients from every one of your areas with the patients billed. Have you accounted each strategy or procedure of each patient that was enrolled? In most of the cases, you will discover missed procedures. It can happen because of an interface issue or a problem with a manual paper process. Taking care of the charge capture process is the first step in the reduction of revenue leakage. If you’re completing procedures that never enter the billing systems, at that point you are working for free. Continuous charge capture is a decent practice to utilize.
- Documentation Quality
You can’t code for what you can’t report. A survey of your documentation is basic to guaranteeing that you are coding consistently and suitably for services rendered by your doctors. It is also very critical to institutionalizing documentation through templates at whatever point possible. Such institutionalization can help guarantee quality control in your final result, which is the last directed report. Understand that documentation examination isn’t the same as a coding review. When we discuss documentation audit, we are talking about the institutionalization of templates.
- Coding accuracy
Is your present medical billing service provider utilizing an auto-coder? Do they use offshores assets? How regularly do they review their coders and process? How frequently would you check the code accuracy? When you have documented for physician services rendered at your practice, you have to guarantee that the proper codes are assigned for maximum repayments. Under-coding is just as rebellious as over-coding. The coding accuracy of the billing services should be accurate and not less than 97%.
- Payer Contract Management
When you have ensured you have caught your work, documented it precisely and coded accurately, now you have to ensure you are being paid by your arranged payer-specific fee schedule. Your medical billing service provider must know that you have contracted so that they can ensure timely repayment.
- Denial Management
You should expect almost about 80% of your expected accumulations or collections will come in consistently if your medical billing service provider uses an exhaustive, continually refined operational process. The performance contrast is in the extra 20%. An intensive denial management process is crucial to guaranteeing full and opportune repayment. Denial management is the core of the performance of any medical billing service provider.