The biggest medical billing challenges in the US and how to conquer them

November 09, 2021
Last updated on November 09, 2021
4 min read
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It’s no secret that medical billing is filled with various challenges. Whether it’s problems with claims, payments, patients, or the people you’re working with, all medical billers have felt the stress of the industry on some level. Medical billing may never become easier, but if you understand the problems you’re facing, it’s easier to make adjustments and problem solve. The following are some of the biggest challenges medical billers face and how to overcome them. 

Patient education

One of the biggest issues medical billers and providers face is keeping patients informed. For the most part, patients don’t have a thorough understanding of medical billing, because there’s no need for them to. However, when patients do know more about their billing, they’re much more likely to make their payment correctly and on time. 

On-time payments 

Late payments can become a huge issue for your bottom line. Whether you’re dealing with insurance companies, patient payments, or both, you’re probably going to experience a few late payments here and there. Cloud-based Medicaid billing software is a great way to track your claim statuses and ensure on-time payments are frequent. 

Accessible payment options 

Your clients are far more likely to pay their bills on time if it’s easy to do so. Offering online payment options, credit card and check payments, and accommodating clients with their needs will ensure on-time payments. Using software will also help ensure payments are received on time. 

Reliable customer support 

If you’re dealing with payers who don’t have a reliable customer support line, you might struggle to submit claims on time or with the correct information. Customer support is incredibly important for billers. If the line of communication is always open between billers and payers and billers and patients, everyone will have the correct information. 

Filing multiple claims at once

Billers often have to file multiple different claims at once. This is only a problem if they aren’t billing with Medicaid transportation billing software, which makes it easy to file dozens of claims at a time. Billers responsible for submitting dialysis claims, for instance, have to file hundreds of claims at a time, which means they have no choice but to find an electronic solution for a productive process. 

Denied claims

We all know the struggle of finding a denied claim in our inbox. Billers deal with hundreds of claims on any given day, have to sort through complicated, ever-growing billing codes, all while juggling other responsibilities. It’s no surprise that this can lead to denied claims every now and then—especially if billers are working by hand. Investing in a medical billing software solution reduces the chance of denied claims and allows billers to submit accurate claims faster. 

Lack of proper resources

Your resources make all the difference when it comes to billing. If you don’t have enough knowledgeable people on your team, proper ongoing education and training, or quality software, you probably won’t see the results you hope for. All of these things are an investment, but they’re a worthwhile one if you want to run a successful billing operation. 

Medical billing software

If you’re using the wrong medical billing software or not using an automated solution at all, you’re not going to operate as efficiently as possible. Finding a solution that’s right for your business is important in the overall success of your company. It’s best to find software that can be customized to your unique needs to avoid having to find a new solution as soon as you need a new add on. 

Poor software implementation 

Investing in medical billing software is the first step, but a successful, informative implementation process should not be dismissed. After all, if you don’t know how to use the software you purchased, you’re only wasting your time and money. It’s crucial that anyone who will be using the software attends all required implementation trainings to make sure they understand how to use the new product. 

Lost revenue

Lost revenue can be caused by a variety of factors including denied claims, time spent on fixing rejected claims, and a slow, inefficient billing process. Your business needs to identify the tools needed to combat these problems and avoid lost revenue at all costs. A few dollars lost here and there won’t break your entire business, but if you’re working with a process that consistently results in lost money, you’re not operating in a substantial manner. 

Take on medical billing challenges with quality software

The biggest medical billing challenges can all be solved when you invest in the right software for your company. If you’re ready to run a better business and say goodbye to errors, hurdles, and billing confusion, it’s time to find the software that’s right for you. The team at BillPro would love to show you a free demo of our software, so you can see the product in action. Request yours today! 

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About the author

Emmy Kolbe is a copywriter at NY BillPro, where she spends her days writing about Medicaid billing software solutions and NEMT industry. She creates content for both emerging and existing transportation companies. She has a bachelor’s degree in journalism and mass communication from St. Bonaventure University. 

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