It costs a lot of money for a healthcare facility to operate. Excellent service isn’t cheap, either. However, revenue streams aren’t always guaranteed as insurance companies are not always the most prompt payers.
Promptly billing clients and insurance providers can help healthcare facilities lower insurance costs.
First, you should understand how the terms of your contract and make sure billing affects your premiums. Now let’s discuss how billing can impact insurance costs.
Understanding the Impact of Billing on Insurance Costs
How does billing insurance work? Insurance in the U.S. is complex because it has so many layers. Over 90% of Americans have insurance—private or government through Medicare or Medicaid. Plus, facilities pay their own type of insurance.
However, because insurers are not known to be prompt payers, healthcare providers must be more vigilant in billing clients.
Medical billing used to be a tedious process, but having medical billing software like BillPro makes things easier, and the process is much faster.
You may also tap an insurance billing company to make the calculations and send out bills promptly. Such companies also use robust software to ensure speed and accuracy.
The sooner the bills are out, the sooner they can be processed. And if the insurance providers take their time processing claims and refunds, you have due cause to make a follow-up.
Getting paid promptly is crucial for the organization to function efficiently. It has to pay its doctors, nurses, admin staff, and other healthcare professionals. Utilities also need to be paid.
Billing insurance companies and private payers promptly will push forward the processing of payments and claims.
Avoiding Common Billing Mistakes That Inflate Insurance Costs
While the goal is to send out bills immediately after a service is completed, it doesn’t mean that speed is the main purpose. The priority must be accuracy—mistakes can have dire consequences for all involved.
Here are the most common mistakes that affect billing:
Billing documents contain medical codes:
International Classification of Diseases (ICD) Codes represent diagnoses, which are also reflected in medical records.
Current Procedure Terminology (CPT) Codes - symbolize the medical treatment and procedure a patient received at the facility.
Healthcare Common Procedure Coding System (HCPCS) Codes - refer to the supplies and products used during the medical procedure.
Billers may make mistakes in their coding, which happens to be for something more expensive than what was actually delivered. The code has been upgraded and, hence, upcoded. Insurance costs will expectedly be bloated.
In some cases, insurance companies bundle the cost of two treatments or procedures that are related or performed together. An example of this is during surgeries where every incision must be closed. Instead of billing incision and closure separately, they are billed together.
Unbundling happens when the two are billed separately, thereby increasing the total.
One of the most common errors in billing is using the wrong code for a disease or treatment. Typographical errors are very common in the healthcare industry, including medical billing.
This happens when the same code is entered twice and, therefore, billed twice.
These mistakes result in the inflation of insurance costs. And when insurance companies get wind of these errors, the claims will immediately be rejected. While it is possible to appeal the mistake, the process is long, and it will delay refunds.
The mastery of how to bill insurance as a provider and avoiding mistakes is key to quick refunds that will be used to pay for everyday operational costs.
Optimizing Insurance Coverage to Lower Long-Term Expenses
Insurance is integral for medical facilities, healthcare providers, and patients. Healthcare institutions must find ways to manage long-term expenses while insurance refunds may take time to reach the coffers.
Healthcare providers are only some of those who can bill insurance companies. They can take these steps to limit operational expenses:
Automate the Process
Use medicaid billing software to automate the billing process. It will minimize administrative costs because you can appoint a skeleton team. It also streamlines the process, eliminating the need to pore through voluminous documents manually.
You can consolidate various administrative functions in one effective software.
Features of robust medical billing software include:
Automatic batch update
Leverage Private Pay
You can leverage homecare services for private paying clients. Revenue from private pay can help the organization immensely.
Efficient Claims Management
It is the right of every healthcare provider to get insurance refunds from covered medical treatments and procedures. You just need to submit accurate medical billing to ensure it won’t be rejected. Using software or tapping an insurance billing company will help, too.
Many healthcare providers depend on insurance refunds for everyday operations. However, insurance companies aren’t always dependable when it comes to timeliness.
To prevent further delays, it is best to leverage Medicaid billing software to dispatch accurate bills quickly. Inaccurate billing is a surefire way to have claims denied.
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