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10 Ways to Make Your Medical Billing Process More Efficient

medical billing process

The United States boasts one of the highest healthcare costs in the world, with the average American paying about $12,500 for healthcare every year as of 2020. While the high healthcare costs are nothing to smile about, they certainly present a promising business environment for medical practices.

However, this is only true for medical practices with accurate and efficient medical billing processes. In fact, the healthcare industry lost a staggering $16.3 billion to inefficient billing processes.


Understandably, the medical billing process is complex and varied. This results in a ton of mistakes that end up doing most medical practices in. If your practice has been struggling with its medical billing process, we’re here to help.

In today’s post, we’ll be highlighting a couple of ways you can streamline your medical billing process for maximum profitability.

1. Submit Claims Every Day

One of the best ways to ensure that your medical billing process is as efficient as possible is to submit claims every day. By doing this, you can avoid having a large backlog of claims that need to be processed, which can often lead to errors and delays.

Submitting claims frequently also lets you stay on top of any denials or rejections. That way, you can resubmit claims quickly and avoid any delays in reimbursement. It also helps you get a better idea of your cash flow.

This information will be very helpful in forecasting and budgeting for your medical practice. If you’re not already submitting claims every day, it’s time you started.

2. Create a Clear Collections Process

Another way to make your medical billing process more efficient is to create a clear collections process. This means having a system in place for following up on unpaid claims.

A comprehensive collection process will involve the following:

Clear Terms and Conditions

The first step is to have clear terms and conditions in place for your patients. This means specifying the length of time you’re willing to wait for payment and the late payment fee, if any.

Set clear terms on what happens if patients don’t pay their bills. For instance, will you send their bill to collections? Will you stop seeing them as patients?

Creating clear terms and conditions upfront will help avoid any confusion or miscommunication later on. It’ll also help avoid any run-ins with patients over delinquent payments. At least patients will understand the repercussions of not making their payments on time.

Collection of Patient Information

The next step is to collect patient information upfront. This includes full name, contact information, insurance policy number, and so on.

Having all this information on hand can help you avoid payment disruptions. This is because you’ll have everything you need to submit a claim correctly the first time.

Address Verification

You need to have a process in place for verifying patients’ addresses. It’s not uncommon for patients to change addresses after moving to new locations. This can lead to a ton of confusion and a lot of money wasted on sending mail to the wrong addresses.

Multiple Payment Options

Be clear about what payment options your medical practice accepts. In addition to cash and checks, you may want to consider accepting credit cards, debit cards, and even electronic payments.

The more payment options you offer, the more likely it is that patients will be able to pay their bills on time. Avoid the one-size-fits-all approach when it comes to payment options. You’ll need to figure out which options work best for your medical practice and go with them.

3. Streamline Your Claims Process

One of the most important aspects of medical billing is claims submission. This is often where things can start to go wrong, which can lead to delays in reimbursement.

There are a few things you can do to streamline your claims process and avoid any unnecessary disruptions. First, be sure to submit clean claims. This means ensuring that all the necessary information is included and that there are no errors.

If you’re not sure how to do this, consider working with a medical billing service. They can help you ensure that all the claims you submit are correct and complete.

Also, consider adopting electronic claims since they’re the quickest and most efficient way to submit claims.

4. Post Remittances the Moment You Receive Them

Posting remittances as soon as you receive them will help keep your accounts receivable low and ensure you don’t miss any denials. Contrary to popular thought, EFT payments don’t mean you can’t wait to post remits.

It can be tempting to wait until you’ve received all your remits before posting them. However, this can often lead to delays and a backlog of work. As a rule of thumb, post remittances within one or two days to avoid delays and missed payments.

5. Be Extra Vigilant for Coding Errors

Coding errors can be a huge headache in medical billing and can easily throw a spanner in the works. Ensure your coders use standardized codes to make the codes easier to understand and decipher. This also makes troubleshooting for errors a cakewalk because everyone reads from the same script.

Consider adopting ICD-10-CM and CPT coding classifications for codes in your medical billing system. While errors can still occur with these classifications, picking out the errors will be a breeze. Also, keep an eye out for upcoding and undercoding, which are mostly accidental, but can sometimes be intentional.

6. Outsource Certain Functions

One way to make your medical billing process more efficient is to outsource certain functions. For example, you may want to consider outsourcing coding and claims submission. These are both time-consuming tasks that can be easily outsourced to save you time and money.

When outsourcing, be sure to work with a reputable company that has experience in medical billing. This will help ensure that the work is done correctly and efficiently. Check out medical billing service reviews online to find the right company to outsource to.

Also, don’t be afraid to outsource other functions, such as customer service and appointment scheduling. These are all tasks that can be outsourced and can free up your time to focus on more important tasks.

7. Keep Patient Files Up-to-Date

Handling claims billing details is impossible without correct patient details. As such, you should ensure you maintain and update patient files as required. This includes ensuring information such as names, addresses, and contact details are correct.

Instruct your staff to verify these details and insurance information during every visit. Although it seems like a lot of work, it’s the only way to ensure patient details are 100% accurate. Plus, with automation, staff members don’t even have to break a sweat to keep patient details up-to-date.

While checking patient details, don’t overlook the mundane details such as the policy number and subscriber information. If these details don’t match up with third-party records, you might have serious payment issues down the line.

8. Automate Billing Functions

In the digital age, automation is almost mandatory for any medical practice.

By automating your medical billing process, you can quickly and easily submit claims, post remits, and follow up on unpaid claims. Automation can also help you keep track of patient records and files, as well as manage appointments.

Consider investing in good medical billing software to help automate your billing process. There are many different software programs available, so be sure to do your research to find the best one for your needs. Alternatively, you can liaise with a reputable software developer and develop custom billing software that meets your specific needs.

9. Ensure Optimum Quality Control

Comprehensive quality control is imperative to the success of any medical billing process. As such, it should be part and parcel of every step of your medical billing process. That way, you can identify errors and mistakes early on before they cripple your cash flow.

Conduct regular audits of your medical billing process to ensure quality control. These audits should be conducted by an independent third party to get an objective view. Remember to use generally accepted accounting practices to achieve just that.

Also, consider creating a deposit log for every receipt that you can send to the billing team. This log should present information in summary and capture all the necessary information needed for the complete posting.

10. Don’t Sideline Delinquent Claims

Ensure you follow up on delinquent claims to determine delayed and unpaid claims. One member of the billing team is enough to keep track of any delinquent claims.

In doing so, they can help establish whether there are any communication issues between your practice and the insurer. Doing so also helps establish whether there are any errors with your medical biller. You can then take steps to rectify these issues and engender a smooth and complete claims process.

It’s worth noting that higher delinquency rates may spell bad news for your medical practice. This is an indicator of bigger underlying problems that could run your practice to the ground if you don’t act fast.

Streamline Your Medical Billing Process Today

Streamlining your medical billing process should be a walk in the park with the information above. Employ the right medical billing strategies and the entire process will run smoothly. Also, don’t forget to employ the right software to automate basic aspects of the billing process.

Lastly, outsource all the problematic sub-processes and save yourself the hassle. Get quotes from some of the leading medical billing service providers to help make the medical billing process seamless.


Author: Mike Cynar

Mike Cynar brings buyers and sellers together by producing reviews and creating non biased webpages allowing users to share their experiences on various products and services. He and his staff write informative articles related to the medical field, legal, and other small business industries.

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