Billing is a sensitive subject to health care organizations, both insurance companies and patients are concerned about coverage costs and final numbers. Thus, when these are inaccurate, stress can increase across all parties.
If this happen too frequently, it may be due to the company’s current billing setup. In turn, an upgrade of systems might be needed, especially in the realms of coding and revenue. Here are three things to work on.
The main issue with incorrect billing can be at the coding level. If procedures are incorrectly labeled, then improper information is sent to the insurance company and the customer. To repair this, a health information management (HIM) solution is required.
This could include packages that repair rules-based code assignments and validation. Some HIM solutions also have evaluation and management (E/M) leveling calculators to ensure everyone is properly notified on their part of their costs.
Revenue Cycle Management
Accurate processing and prompt payments are essential to a successful healthcare organization. This is why Revenue Cycle Management, or RCM solutions, are an important cornerstone. This can represent any number of components. For example, an organization may only need Accounts Receivable or Payable modules. Or, they require end-to-end RCM Solutions to handle all aspects of payment and billing.
Unfortunately, HIM and RCM Solutions may not be the main problem. It can be a lack of training on the available products. In this case, retraining and cross-training is a must. Without these, even the most updated software won’t solve an organization’s problems. However, when time and patience are applied to review new or existing solutions, then productivity and accuracy will increase.
In the end, to help audit your current needs, contact GeBBS Healthcare Solutions. They can tell you if updated software, additional training or both are needed to rebuild confidence in patients and insurance companies.