Skip to main content

Issues That Affect Pain Management Billing & Revenue Cycle

June 26, 2018

Pain-Management-Billing-IssuesMedical billing is the backbone of any pain management practice revenue cycle. Unfortunately, many pain clinics experience some big challenges with accurately and efficiently billing payers and patients for services. The medical billing process includes multiple steps, various healthcare stakeholders, and communication across payers and departments to run smoothly. Effective medical billing is essential to reducing the number of days in accounts receivable and optimizing your clinic’s revenue cycle. Unfortunately, there are some big issues that can affect your revenue cycle, and for many pain clinics, outsourcing medical billing can offer an excellent solution. 

4 Billing Issues Affecting Your Pain Management’s Revenue Cycle

Four of the top billing issues that may be affecting your pain management’s revenue cycle include:  

  • Failing to Capture Patient Information Accurately Results in Delays in Claims Reimbursements – Medical billing begins at the very first point of contact between your clinic and a patient. It’s essential to have front-end staff trained to collect patient information accurately, laying the groundwork for billing in the future. Correct demographic information, insurance verification, and determining eligibility up front are extremely important. In fact, eligibility issues are one of the top reasons claims are denied.  
  • Administrative Delays as a Result of Manual Claims Management Processes – Many pain clinics continue to use manual processes to deal with denials management. While the revenue cycle still requires some manual processes, which can lead to inaccuracies, automated solutions for pain clinics or simply outsourcing billing and claims tasks can help improve important performance indicators, such as claims denials, case mix performance, and days claims are in accounts receivable. 
  • Failing to Inform Patients of Financial Responsibility Causes Collection Issues – Recent analysis by TransUnion Healthcare found that during 2017, patients saw an 11% increase in their average out-of-pocket healthcare costs. This increase in patient financial responsibility means that pain clinics cannot afford to fail to inform patients of their financial responsibility. More pain clinics are finding it more difficult to collect payments from patients because they now have greater financial responsibilities. 
  • Continual Problems with Inaccurate Coding – The top medical billing error for pain clinics and other types of practices continues to be inaccurate coding, and pain clinics deal with very unique codes that come with pain management procedures. Improper codes, simply mistakes, incorrectly coding medical services, or not staying current with coding changes can result in errors that become costly to your pain management. 

Benefits of Outsourcing Medical Billing Services

Since pain management clinics deal with some big medical billing challenges that have the potential to impact their revenue cycle, choosing to outsource these services to professional billing and coding companies can prove useful. Outsourcing billing services can allow pain clinics to reorganize and streamline billing procedures, ensure claims and bills are submitted on time, and maximize their clinic’s cash flow. 

Related Topic:  Medical Billing Company can help reduce payroll costs, increase revenue, and ensure compliance

It’s essential to submit accurate claims and bills at the correct time, but pain clinics have a high number of patients and may have a tough time keeping up with billing and claim procedures. Working with an experienced medical billing company often increases efficiency for pain clinics that are struggling. Just a few of the benefits pain clinics can enjoy when outsourcing their medical billing and coding include: 

  • Reduce staffing expenses
  • Savings on office operational costs
  • Reducing bulk paperwork in the office
  • Reducing the workload on current staff and saving time
  • Improving the efficiency and productivity of the pain management
  • Saving the investment needed for infrastructure, resources, and equipment to take care of medical billing in-house
  • Allows the pain management to better concentrate on core competencies
  • Fewer denials due to improved accuracy
  • Fewer days spent in collections
  • Maximized cash flow

Major Pain Management Medical Billing Services

Pain clinics considering pain management medical billing services will want to select a company that offers high quality solutions using the latest tools and technology. Quality outsourcing companies are equipped with expert medical coders, billing specialists, quality analysts, and other experts to ensure the billing process runes smoothly. Some of the major pain management medical billing services to look for when choosing a service include: 

  • Coding and audits
  • AR management (patient and insurance)
  • Patient schedule and patient reminders
  • Insurance verification
  • Insurance enrollment for offices and providers
  • Insurance pre-authorizations
  • Billing and accounts reconciling (payment posting) 
  • Patient enrollment (charges and demographics)
  • Account analysis
  • Financial management reporting
  • Denials management 

Core Features That Make Professional Medical Billing Companies Stand Out 

Professional medical billing services can provide complete medical billing solutions for pain clinics and excel in service quality and data accuracy. Some of the core features that make medical billing companies stand out above the rest include: 

  • Offering secure file transfer options
  • Careful, clear analysis of all accounts
  • Fast turnaround times
  • Monthly and weekly status reports
  • Strict quality assurance
  • Implementation of the correct billing and coding procedures
  • Staying up-to-date on codes and medical reimbursement norms set by insurance companies and the government
  • HIPAA compliant billing and coding solutions
  • Free trial options
  • Affording pricing to help pain clinics save both time and money 
  • Transparency of data
  • Long term partnership and support

As the healthcare landscape continues to change, effective billing and coding is essential for pain clinics that want to keep their revenue cycle moving and increase their cash flow. Unfortunately, multiple billing issues have the potential to negatively impact the billing cycle. For many pain clinics, making the choice to outsource medical billing is a wise one that reduces overhead and improves cash flow. To learn more about how M-Scribe can help your pain management maximize cash flow with professional billing and coding services, contact us today at 770-666-0470 for more information. 


Get the Latest RCM News Delivered

Receive practical tips on medical billing and breaking news on RCM in your inbox.

Get in Touch