Top 4 Tips for Efficient Healthcare Claims Management
New healthcare reforms that focus on population health management and bundled payment models are keeping healthcare staff occupied. This has led to inefficient denial management, missing documents and under trained staff, which are some of the factors impacting the medical claims management process. To combat declining rates of claims reimbursements, revenue cycle experts are now looking for new strategies that streamline efficiency and cut down costs within the healthcare system.
While patients turn to hospitals for quality healthcare, the providers’ businesses rely on striking a balance between meeting the market and the consumer demands. If you are also in a quest to improve your healthcare claims management, then here are top four tips to implement.
- Accurately Collect & Save Patient Data
The key to complete trouble-free reimbursement is accurate patient data. This data provides information on deductibles and policy numbers of the patients. Patient data is then used to validate critical billing related patient information such as patient’s address, policy number, etc. with the payer records, which will be with the third party insurers. Patient name, account number, invoice number, service charge and treatment date are some of the critical fields to be captured.
- Training and Retaining Resources to File Error-Free Claims
Frequent training is important to keep your staff updated with all the latest billing guidelines and improve your claims management process. Payers often have a distinct set of rules to onboard new patients and process claims. While some payers rely on patient data for follow up care or non-standard treatments, the others use patient data to establish primary care relationships. Thoroughly training the medical billing team helps them understand the importance of collecting and storing patient data for future use.
- Streamlining Your Denial Management
Having a structured plan in place is necessary to efficiently handle claims denial. Regularly providing claims management training to your medical billing team will help you to reduce the rate of claims denial. Backtracking coding methods is yet another way to minimize claims denial. Furthermore, healthcare providers can relook at the verification process and coding strategy and improve it to decrease claims denial.
- Evaluating Your Quality Control System
Periodically evaluating your quality control measures can be a great way to improve your entire claims management cycle. This helps providers to devote more time to critical tasks. Repeated claims denial can impact the quality of your healthcare service. Setting standard accounting procedures to handle payment records will help you to monitor your cash flow. The deposit data can then be monitored and every receipt can be forwarded to the billing team to update the account balance.
Conclusion
Apart from all the above discussed tips, you can also investigate faulty claims and frequently analyze faulty accounts to optimize your cash flow. The best option is to have a highly organized strategy, which helps you to quickly file claims, improve revenue and maintain a smooth communication with your stakeholders.
Constantly reviewing your billing cycle will make reimbursements highly effective and improves cash flow. Implement these tips in your revenue cycle to process denied claims and efficiently manage claims.