Outdated Medical Billing Practices Can Result in Lost Revenue

money in rubber bands


The average medical practice relies on patient payments for nearly 40% of its total revenue, though patient responsibility percentages continue to rise. With so much money at stake, your office can’t afford to be operating on outdated practice management software. Thousands of dollars may never make it into the company bank account if patients and insurance companies aren’t billed correctly and payments aren’t collected. Medical billing is the heartbeat of the practice’s finances, and outdated processes can negatively impact profit and revenue streams. 


Moving on From the Medical Billing Practices of the Past 

There have largely been two players in healthcare finances, though this is when looking at where the money comes from. There is the patient and the insurance company. As the healthcare industry has seen some major overhauling in the last few years, more payers are becoming extremely particular about which claims will be processed and which codes or line items are acceptable. This can lead to an increase in denials and rejections, and without follow-up, this is lost money. Patients can be equally problematic when it comes time to collect money. 


Medical collections processes can be very effective when set up the right way. Failed medical billing practices can a lot of times be the root of a revenue problem. An efficient medical management and collections that consistently delivers quality services to patients will go a long way in customer service. 


Seeing the Problems With Outdated Practices 

The most significant problem with outdated billing systems is the loss of revenue. However, the patient experience (whether by way of an unexpected bill or an insurance claim denial) has a long-term impact on the longevity of a practice. Profit becomes a problem when too many expenses are incurred trying to fix billing issues or track down payment. Over time, medical practices can hemorrhage thousands of dollars because of these inefficiencies. These are a few of the most common areas of concern. 


  1. Failing To Keep Up With Regulations 

The healthcare industry has seen a tremendous number of new regulations handed down over the last few years, and medical billing is no exception. It takes both time and money to keep staff trained on the most current procedures or requirements, as well as to continually update the electronic record systems. Diverting staff in these areas can leave gaps in patient services but failing to keep up with the new laws can also lead to costly fines or liabilities. 


  1. Failing To Be Diligent With the Details

One of the most serious problems in healthcare billing is revenue lost to leakage. Some practices or institutions face up to a minimum of 10% loss of revenue on account of leakage. Many of these denials come from patient data that is missing or incorrect. Whether it be the front office not verifying insurance prior to services being rendered or simply typos in the processing, medical practices are losing money by not being detail-oriented. Organized and robust medical billing software can be the key to solving this issue. 


  1. Failing To Get Control of Denials 

The smallest errors can trigger rejections, and this starts an expensive process of fixing claims and then resubmitting them. However, many offices or practices don’t have a process in place to catch error triggers or track denials that have come back. It takes a tremendous amount of time and overhead expenses to correct errors and repeat submissions. Any extra expense leads to a loss in profit. 


Moving Toward a Better Solution 

Streamlined medical billing and friendly helpful customer service is a great way to keep patients happy and more coming in the door. Digital practices such as telehealth have become a way for patients to get the care they need without significant expense or exposing themselves to unnecessary germs in today’s conditions. Telehealth digital services can replace in-person visits while also bringing in revenue with very low overhead. Patients can pay a flat fee prior to their virtual appointment, this can also eliminate much of the complications with patient billing and insurance coverage. 


Consider the benefits of working with a medical billing consulting company like PracticeForces. The partnership takes a huge financial responsibility off of the physicians at medical practices, as this third party works to issue invoices and collect payments. Insurance denials are not a problem, as our specialists are able to track and follow-up on claims that haven’t had any response or that have been denied. 


You won’t be wasting money scrambling staff to catch payments or make contact for insurance rejections. When your staff can focus on delivering the best care to patients, you will see the practice grow and increase its revenue stream. Call us today or get a quote to see how we can help streamline your medical practice billing and collections.

Parul Garg, CEO and co-founder of PracticeForces, has significantly contributed to the growth of over 1,000 U.S. medical practices through her expertise in medical billing and coding since the company’s inception in 2003. With a background in Computer Science and an MBA in Human Resources, her leadership and AAPC-certified coding skills have been pivotal in managing the company’s operations effectively.

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