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Medical billing issues that impact the healthcare revenue cycle

Manual claims equate to more AR days,
which contributes to administrative

encumbrance

Most healthcare providers know that submitting claims
is a cyclic game. Providers should employ robust data
collection applications, open the lines of communication
between the front-end staff, and streamline the denial
process. Even with certain automation in place, not all
manual processes are eliminated and, therefore, will
need to be addressed. These painstaking processes can
quickly add up and lead to inaccuracies. Incorporating
additional automated solutions into your process will
enable providers to monitor and improve performance
earlier in the revenue cycle process.

Incorrect medical coding results in the
most medical billing errors

Incorrectly or mistakenly coding increases claim denials.
A coder’s job is to code to the highest level of specificity.
Coding to a general level or undercoding can cause a
claim to be rejected or denied. Another point to consider:
at times providers are not always available to consult
on difficult-to-understand claims, and more importantly,
coders fail to use current/updated code sets. It is the
coder’s responsibility to learn, through updated manuals
of new and revised guidelines. Continuing education is
imperative to maintain a level of skill and astuteness in
the ever-changing world of medical coding.

Reducing days in accounts receivable is an ongoing process of addressing challenges that can be resolved by
implementing a well-managed and efficient billing workflow system with effective setups. From the moment the
patient registers to the final posted payment, upper management involvement should include overseeing the
process to ensure that employees understand their roles and are following established guidelines to guarantee
prompt payments. After all, what matters is your client’s satisfaction.