Effective Medical Billing Strategies to Increase Healthcare Reimbursements

It is an undisputed fact that the healthcare reimbursement system (as it is) can be described as brutal. The present set of processes and rules that some payers and insurance companies have put in place are not only complex but also confusing. This leads to the emergence of other problems like underpayments, denials, ignored or at times lost claims.

This has hugely contributed to issues when it comes to paying doctors in time as well as medical practices getting the revenue they generate in full.

This begs for there being in place effective strategies and insights that will help medical practitioners and health centers to improve their patient billing processes. This will help them generate more revenue as well as increase their healthcare reimbursements.

Use of Technology

Whenever a medical practice realizes that a claim is not paid for when they submit the claim for the first time, they should brace themselves that it will not be paid. In order to escape losing out on claims like this, the practice has to find ways that will help it establish potential denials before even submitting their claims. Medical practices could be able to achieve this feat by incorporating software in their systems that is capable of identifying claims with a high probability of being denied automatically.

This billing software utilizes an engine that is intelligent and one that adapts and updates itself constantly thus helping practices to stay informed and alert about denial trends that are latest in as far as claims are concerned. This will greatly improve the rates at which practices collect their revenue. This software is generally able to help the practices improve on the speed at which they collect, decrease the need of having in-house staff as well as increase first pass resolution rates.

Tackling Underpayments

Payer underpayments are another issue that keeps medical practices from collecting their full amounts of revenue. This is largely due to the different individual contracts doctors often enter into with different payers. Underpayments are far too common in situations for health center billing, specifically federally qualified health center billing (FQHC billing), as these community health centers are focal to serving low income patients who utilized Medicare and Medicaid.

This is the key reason why medical practices receive different amount of monies from the different payers. This makes it hard for the practice to keep track of the payments and hence making it even harder for them to realize when they are being underpaid.

It is for this reason that practices ought to turn to using medical billing software that is able to compare the payments it is receiving against the figures agreed to in the contracts automatically. This will largely cut short the number of payer underpayments scenarios. It will also increase the net collection rates, increase organization and efficiency of the practice and make it possible for the practice to forecast its collections in future.


In order for a medical practice to realize its position as far as payer payments and collection rates are and the areas that need an improvement, reporting ought to be embraced. This can be done with software that is capable of allowing scheduled reports on the practice to be done at defined intervals.

This will give the practice the opportunity to have certain reports in an instant whenever it is needed. These reports make decision making easier, increase productivity (as it reduces staff requirements and make it easier to spot payer underpayments and other mistakes.

All the above solutions will ensure that your practice is able to collect more revenue thereby turning them into more revenue generating practices. They will also ensure that the practice increases its healthcare reimbursements. It also makes the collection of monies owed to the practice easy, fast and efficient.

For more quality information on how medical practices and health centers can improve healthcare reimbursements, visit MaximizedRevenue.com

No comments:

Post a Comment

Note: Only a member of this blog may post a comment.