7 Factors That Will Optimize Your Medical Billing Process

August, 30 2016

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Ever since medical billing and coding went digital, many practitioners assume that the chances of mistakes have been more or less eliminated. Those who run small medical practices know that is not the case. Since the arrival of the Affordable Care Act, your revenues have probably been going downhill, and your billing and record keeping has probably grown far more complex.

Small practices with modest resources need to optimize their medical billing and maximize revenues. Here are seven tips to help you and your billing department boost your skills and your revenues.

[WHITEPAPER] Our best tips on getting you paid.

7 Ways to Optimize Your Medical Billing Process

Shop Around

Compare products before buying your billing software. Not all billing programs are made the same, have the same features, or are as well supported. Also, be sure the software you buy is tied to estimable Clearinghouse organizations.

Become a DIY Billing Expert

Take the time to learn everything there is to learn about medical billing. There’s lots of free information available online, and even free classes here and there- if you look hard enough. Take the time to become an expert. This will enable you to spot trouble and opportunity when it strikes. Also, make sure your billing staff has done their homework as well.

No Excuses, Here are Some Resources

There are lots of terrific resources available online if you’re willing to sort through all the noise. Here are three examples of terrific free resources for learning the basics of medical billing:

  • Overview on Claims Processing -  They offer a 15-course overview of the entire medical billing process. While they have their own objective on this site, as a provider, you can glean a great deal of valuable info from this course.
  • Medical Billing Videos - This is an online depository of videos that will help you learn all the ins-and-outs of medical billing. The courses are self-paced and excellent as refreshers or introducing the subject of coding to your staff.
  • Coding Training - Offers excellent training videos that are accessible and very informative.

File Now, not Later

File claims as soon as you can. If you coded for a claim and reviewed it as well as you are able to, submit it without delay - claims submitted immedicately are more likely to be collected upon than those that linger for months. Do not collect claims to file all together: Get them filed as quickly as possible.

Read the EOB

Make sure you read the EOB carefully. Sometimes insurers will pay for only part of a procedure- not all of it, leaving you to pick up the slack. You may have the right to more than just the reimbursement check you received. Especially these days, with the particularity of ICD-10 claims, make certain your entire bill is paid.

Always Check Claims

Checking claims should be an ongoing process. Your staff should actively monitor old reports to identify claims that have been ignored and need attention. Many small practices don’t do this– they just try to notice when payments are delinquent, and then act on them. Practices that do this are losing money on claims that don’t make it to the insurance company, denied claims where notice of denial never comes, and checks that never seem to arrive. These little things can add up to a lot of lost revenue.

Read Clearinghouse Reports Carefully

Read clearinghouse reports thoroughly to make certain you don’t overlook any problems. Be sure to appeal any denials as quickly as possible. The longer you wait after a claim is denied, the less important the claim will seem to be, and the less likely it is that you actually can collect from patients.


 Medical billing software has only gotten better in response to ever-increasing patient consumerism. But it is still only as good as the people using it. If you and your billing staff have a firm understanding of what you’re doing, and the software you’re using your revenues are bound to increase.

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