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For any business, it is important to watch the money closely to maintain operations and achieve a profit. This guideline holds true for Medical Practices as well; while it may be true that doctors can make a lot of money, it is still just as important to manage the revenue cycle properly to ensure a successful medical practice. Read on to learn the seven steps necessary to properly manage medical revenue.
Processing Your Medical Billing
Before anything else can be done, you must determine whether you want to use in-house billing software that you or a team member can implement and maintain or outsource your billing processing to a third party. Using a Specialized Medical Billing Outsourcing partner can achieve better results for the Medical practice with less admin burden for the owners and leaders of the practice. While there are many mass marketing companies doing billing, not many achieve consistent results for each client.
Verifying Benefits and Coverage Eligibility
Prior to seeing the patient, the front desk team performs a first step in medical revenue management by verifying a patients benefits and insurance eligibility. This helps your practice determine how much money it will receive from patients themselves and from insurance companies. Current Revenue Management software can check a patient’s eligibility using the real time eligibility.
Submitting Claims
This step is absolutely crucial, as no money will head your way until you submit claims for the work and services you’ve performed. Using error detection software can be a huge help during this step as well as Pediatric specific medical team that reviews the claims prior to processing.
Posting Payment
Following the claim submission, the cost of that service is posted so your patient may pay whatever costs the insurance companies do not cover. Modern software can make payments consistent so your patients pay with ease and your medical revenue management goes smoothly.
Managing Claims Denials
Denials of claims can add up and cost your practice revenue, so looking into patterns of denial is important. Managing habitual denials can help you smooth out your revenue flow, and nipping billing problems in the bud ensures you get the revenue you deserve. A strong Pediatric Medical Billing team will manage this consistently. Unfortunately, some internal billers and billing companies have inadequate follow-up on denied claims on both the insurance and patient side.
Reporting Revenue and Finances
Keeping detailed records of your practice’s finances is important, as well as maintaining records of performance so you can improve your success rates. Treating patients well will yield good results, and managing your revenue efficiently should keep your practice’s coffers happy and healthy.
The revenue cycle looks involved, but thorough medical revenue management is necessary to a sustained medical practice. Keep a close watch on the money, and the money will stay close so you can continue to treat your patients first and foremost.
