Seven Important Things a Medical Biller Should Follow to Increase the Revenue

by | Published on Oct 5, 2012 | Medical Billing

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Medical billing and coding is extremely challenging in today’s world because of frequent changes in rules and regulations, guidelines and payer policies.

AAPC member Ellen Risotti-Hinkle says, “There are many things a medical biller can do to help them stay current on changes, as well as to ensure claims are billed and processed correctly. I’m amazed by some of the things medical billers should be doing, but aren’t.”

Seven things a medical biller should follow to increase revenue:

  • Better knowledge of Local Coverage Determinations (LCDs)

This will help to understand clearly the circumstances under which the procedures are covered, as well as get details about coding guidelines and reimbursement.

  • Verify the denials

Sometimes the claim may be made correctly but the insurance companies or the billers can make some mistake and this may lead to claim denial.

  • Don’t be scared of appeals

Payers do not always follow the proper guidelines. You can often have a claim settled easily by providing documentation as to why that claim deserves reimbursement.

  • Check your electronic submission reports

It is used to check whether claims are submitted and received by payers. The reports also show the rejected claims. With the help of these reports you can find the mistake and again resubmit the claim for a speedy approval. Claims that didn’t reach the payer can also be investigated and errors corrected.

  • Know the exact fees

Know the exact amount the payer should reimburse and calculate the exact payments to prevent loss of money.

  • Register and use the payer’s website

The billers should register all details of the patient in the payer’s website. So it will be easy for the biller to know all details such as eligibility and claim details.

  • Keep updating knowledge

A medical biller should refresh his knowledge regarding the changes and updates occurring in the medical billing industry. Thereby financial loss can be considerably reduced.

Medical entities can avail of outsourced billing and coding service that will ensure perfect medical billing and accurate reimbursement. Outsourcing can help reduce claim denials and improve your revenue cycle. There are many online outsourcing companies offering a free trial option for their services. This will help evaluate the service quality and turnaround time.

Julie Clements

Julie Clements, OSI’s Vice President of Operations, brings a diverse background in healthcare staffing and a robust six-year tenure as the Director of Sales and Marketing at a prestigious 4-star resort.

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