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Tools and Tricks for Improving Healthcare Reimbursement Cycle

November 12, 2013

There are few medical practices that that don’t want to improve their revenue streams, increase reimbursements or reduce their accounts receivable aging. With the coming (October 1, 2014) transition to ICD-10 coding, sure to increase rejected and delayed claims, at inception–and, possibly beyond, techniques to improve reimbursements, payments and collections are vital.

Along with over 60,000 new diagnosis and procedure codes to be learned, ICD-10 implementation also includes a different code structure, from three to five characters to three to seven characters. This change offers many more “opportunities” to file inaccurate claims. Inaccurate claim submissions result in delayed payments, at a minimum.

Top medical billing and consulting firm M-Scribe Technologies and offers the following proven tools and tricks to improve your reimbursement payments cycle. Use one or more of these suggestions to keep your revenue stream strong and healthy.

Tools and Tricks

  • Speed net revenue and collections by paying closer attention to A/R aging. Accounts receivable aging issues are sometimes akin to having a negative corporate culture; it’s easier to complain about working conditions than improve them. Install a policy that forces you to pay close attention to the practice A/R aging. Every time an account or reimbursement moves into a longer days category (e.g., from 30 to 60 days), the timing of your income stream is damaged. Having the practice manager or another designated employee to manage A/R will accelerate revenue and reimbursement collections.
  • Get ready for the shift to fee-for-value services. As more payers change their reimbursement approach that feature fee-for-value, instead of the simpler fee-for service model used forever, practices also must design modified revenue management procedures that address these changes in focus. If you neglect this, practice income will suffer; if you adapt to the change, your payment timing will improve.
  • Adopt updated claims submission and revenue management policies. The transition to the more complex ICD-10 coding system, projects to hurt your revenue receipt timing with inaccurate claims documentation. Update your claims submission policies now so your staff becomes comfortable with different payer claims procedures well before the code transition. This action will minimize delayed claim payments upon ICD-10 installation, while improving reimbursement timing now.
  • Install streamlined payer audit and compliance procedures. In addition to anticipated increased CMS RAC audits and commercial payer audits, new regulations are complicating compliance requirements. Design procedures your risk of incurring fines and penalties, while encouraging lower staff time commitments spent away from their normal duties with auditors. Even just keeping claims and compliance documentation organized and handy will accelerate collections and audit on-site presence.
  • Design controls to minimize claim rejections. This is an obvious tool to reduce income delays. The coming transition to ICD-10 coding makes this a necessity, not just a good idea to increase collections and improve timing of payments. Even if you make corrections to a rejected claim to receive an “accepted” decision, your reimbursement will be delayed increasing your A/R aging, possibly by 30 to 60 days. The solution: Have someone check your claim documentation before submitting, making sure patient and insurance information is up-to-date.

If these look more like common sense tools than complex tricks, you’re correct. Your practice should already be using these techniques to maximize revenue and minimize payment timing delays.

However, thriving medical practices typically involve busy days with sometimes harried staff. Other important issues, like revenue maximization sometimes take a costly back seat. Billing mega dollars is wonderful, as long as cash collections keep up with billing on a current basis.

Using one or more of these tools will help achieve this goal. Don’t neglect to consider a top medical billing firm, like M-Scribe Technologies, to minimize timing delays and improve reimbursement receipt. This cost-effective option is becoming a more popular choice of many medical practices for one reason–it works.

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