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Medical Billing is one of the most important functions of a medical practice. Medical Billing is part of the revenue cycle management process of a practice. So, medical billing is much more than submitting claims to insurance companies and waiting to be paid for those claims. The revenue cycle management of a medical practice is a complex process that involves: insurance verification, patient demographic entry, medical coding, charge entry, claims submission, payment posting, patient collections, denial management and reporting. In order to ensure financial success, medical practices must put in place a solid revenue cycle process. Putting in place the steps that the practice staff needs to ensure that every step of the revenue cycle management process is worked will save the medical practice money and will increase revenue in the long run.

At the center of the revenue cycle management process, is patient collections. Current trends in medical insurance are putting more responsibility on patients due to higher co-pays and higher deductibles which patients are responsible for. Also, patients that have no health insurance are responsible for paying the medical services they receive. A good patient collections process will make the revenue cycle management process runs smoothly. Moreover, having a good patient collections process will ensure that the medical practice gets the money patients are responsible to pay.

One of the best practices that medical practices should implement is to set patient collection expectations up front before the patient gets seen or during the patient’s visit. Not discussing patient collection responsibilities up front can damage the relationship between the medical practice and the patient when a bill is sent to the patient after the visit. It is not uncommon for patients to dispute and fight a medical bill when they are not made aware of their responsibilities up front. Sharing patient payment responsibilities up front will set ground rules and will make patients be aware of their responsibilities after they receive care.

Medical practices must make sure that they obtain patient insurance coverage and eligibility before the patient shows up for a visit. Providing patients with the copay and deductible responsibilities will set payment expectations up front and will prepare the patient to receive statements from the practice. A good practice management system can provide eligibility and coverage information to the practice on the spot saving the practice staff time from calling the patient’s insurance company. Ass an added benefit to the practice processes, a printed copy of the insurance coverage and eligibility information can be provided to patients from the get go as a way to engage them in the collection process.

Medical practices must also make sure that once patients are aware of their coverage and eligibility benefits, they collect patient co-payments at the time the patient walks in for a visit. It is good practice to let patients know in advance how much they will be expected to pay when they come in for a visit and how much they will be expected to pay after the insurance processes the claim.

To conclude, in order to improve their patient collections, medical practices should:

1. Educate and guide patients on their insurance coverage and eligibility.
2. Inform patients of their financial responsibilities at the time of check-in, prior to coming to a visit or when booking the next visit.
3. Make sure that your practice has an up to date practice management system that will allow you to check benefits and track patient balances.

At Vitruvian MedPro Consulting, we are more than medical billers. We are certified medical reimbursement specialists by the American Medical Billing Association. We can help medical practices at any stage of the revenue cycle management process. Our goal is to help medical practices improve cash flow and focus on patient care.

Please visit our medical billing page to learn more about our services at: Medical Billing Services

We are currently offering a free practice analysis to help medical practitioners determine whether it makes sense to outsource their billing. Gives us a call at 781-454-7406 and schedule your free demo.

At Vitruvian MedPro, a Brookline, Massachusetts medical billing and practice management company, we work with independently owned medical practices on any aspect of their revenue cycle management. Besides medical billing, we help medical practices with their coding, account receivables and HIPAA compliance. We make sure that practices receive the highest reimbursements from the insurance companies.

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