All healthcare organizations aspire to cut on the denials to enhance the outcomes from their revenue cycle. Effective denial management and error resolution is a time consuming exercise which requires specific technical knowhow in the field of medical billing. Revenue losses due to billing errors tantamount to serious threat to medical practices. Most commonly the denials are due to coding errors like incorrect coding, unbundling and up-coding, the specific reasons for which are incomprehensible to the coding staff due to adequate knowledge. Discrepancies are often found when itemized invoices are scrutinized. Even after the underlying cause of the denial is figures it may take up to several days to correct the issue and follow up. Throughout the process of revenue cycle management, there is always scope for human error as most hospitals and health systems work towards claim submission. However, a proper audit of charges, codes and claims can help healthcare organizations in maximizing their reimbursement.
Having a skilled set of staff working towards easing out the burden levied by denials on the practice is important for maintaining a revenue management cycle that thrives. Using latest technology, developing a strategy and paying close guided attention to the cause can help in denial resolution. Working towards improving the patient accounting, EMR or claims management system workflows helps a great deal in averting these unwanted denials faced against the claims made. Sometimes when it becomes difficult to recruit staff that is versed at this particular skill set of medical specialty you can always seek help from a professional medical billing and coding company who put in place custom made mechanisms to generate optimal revenues from your practice. Auditing claims allows a healthcare organization to ensure that you would be paid in full according to the services you provide. This makes auditing a crucial practice.
Here Are Some Tips On For To Reduce Medical Billing Errors With Auditing:
Identify Missed Billing Opportunities with Technology
For a successful RCM audit you need to choose an automated tool programmed so that it identifies potentially missed charges and/or overcharges with help of predictive analytics. Using such a tool would allow the organizations to evaluate their revenues more intricately.
Honing the Right Skill Set
It’s important to have the right person conduct the RCM audit. It can be someone from an outside company or can even be somebody within the organization. It is essential for an auditor to understand the working of the organization’s billing process and guidelines associated with it. The auditor should also be capable of reading medical records as well as itemized bill, along with basic analytical skills. It’s beneficial to have someone qualified to do audits for they would be able to understand where an organization might see potential issues and if there are any concerns the organization needs to address.
Treat At Source
After detecting a discrepancy, hospital must reach its source. Furthermore, the institution must check for similar errors in the past with help of the auditor. Reaching the root cause of the error helps in preventing it from happening again and subsequent losses.
Audit Frequently
Scrutiny in the form of audits is significant for a healthy functioning revenue cycle. Auditing on a continual basis ensures greater accuracy of claims which is followed by submission to payers. Frequently auditing the records means lesser chances of facing denials and greater revenues in return.
Why Medical Billers and Coders (MBC)
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