Services in the healthcare industry are more complex than their commercial counterparts. In this case, your clients don’t just come in, purchase a medical product or service, and walk out.
Instead, service starts the moment they book a consultation, whether online or physically, in your clinic. It extends throughout their continuous visits for treatments and regular checkups and only ends when they’re no longer your patient.
While state-of-the-art care is essential, your practice is still a business. It’s important to keep a carefully-planned financial plan throughout the patient’s journey. Since the healthcare industry’s billing cycle is highly complex, and you often have to handle hundreds of patients simultaneously, you need to implement efficient and proper billing into your practice management.
At Patient Check-in
During your first interaction with the patient, collect their billing and insurance information. This allows you to figure out their billing process early on. Also, you’ll know whether their insurance policy provider covers your practice and the patient’s condition or if you’ll work with an out-of-network patient.
Submitting Claims to Healthcare Insurances
After the first visit and determining the patient will frequent your clinic, it’s time to submit a claim to their healthcare insurer. That way, when it’s time to bill your patient, everything is ready and has a place in your billing cycle and clinic management.
To submit an insurance claim, start by requesting a claim form from their insurer and combining it with the patient’s itemized bill. Whether you decide on filling a paper or online form, make sure you make copies and digitize the patient’s information for future reference. Finally, review all the information in the claim and submit it. Note that when a patient is out-of-network, they’re responsible for filling out and submitting their own insurance claims.
When it comes to including the insurance company in the patient’s diagnosis and treatment, you can’t describe their condition. Healthcare insurance companies often rely on a strict medical coding system, where the patient’s diagnosis, performed procedures and medical service, and equipment used are categorized into universal alphanumeric codes.
Update, Update, Update
While the process of submitting a claim might seem fairly straightforward at first, imagine doing it for hundreds of patients half a dozen times daily, all with different insurance providers, conditions, and unique situations. Even using an electronic system isn’t enough without properly updating the data when there’s a change.
During each step of submitting an insurance claim and billing process, make sure your system is up-to-date. This ensures you know which steps are complete and which aren’t, in addition to catching billing errors early on before they become much larger problems. An updated system will also allow you to see what’s left in the accounts if the insurance coverage was partial, when to bill your patient directly, when they post the payment, and if there were any issues.
Rely on Technology to Get it Done
As a practice manager in the modern world, you likely already have practice management software, but are you using it to manage your billing cycle? If so, what changes can you implement to make it more efficient?
Technology isn’t used just to keep records; you can rely on tech to automate as many tasks as possible by implementing NextGen medical billing software. That way, you and your billing staff don’t have to submit and process claims manually, along with tracking billing and payments every time. Instead, you can reduce the overall burden and error by simply entering your patients’ information into the system and letting it do all the work.
Dealing With Transferring Patients
Patients have the right to transfer their healthcare needs to a new provider. It could be because they’re changing location, purchasing insurance from a different provider, or simply would like to try care from someone else. Either way, you need to make sure you settle all bills and due payments before you fully releasing them.
Additionally, you need to figure out how you’ll transfer their medical records. Does their new care provider also digitize their records, or do you need to print and securely transfer the documents? Also, is this a free service, or will you charge individuals?
Doing it the Right Way
With more and more people becoming aware of their health and the importance of regular healthcare, it’s important to be prepared for their demands. More patients equal more billing and more transfers in general, and without well-optimized billing systems, it’s easy to fall behind. Do it right from the start and use the help of technology and specialized software in managing your practice.