Submitted on Wed, 2013-05-08
By Nar Ramkissoon

The biggest problem facing any health clinic is their ability to collect money from patients. 

medical billing best practices

This is especially beneficial for public health departments, where funding is stagnant or dropping, but demand is rising. Following medical billing best practices can actually help increase revenues by up to 70%.

Following the six tips below can help any medical practice improve their billing and claims process to increase office efficiency and boost revenues:

Medical Billing Tip #1: Allow Visits by Appointment Only

Creating a consistent scheduling plan is the first step in optimizing billing success. An appointment-only scheduling structure promotes insurance verification prior to service and it also leads to greater accuracy in capturing necessary billing information. Such a setup may be difficult for public health agencies to transition to, but it’s a vital step in cleaning up and optimizing the claims and billing processes. One idea to make this easier would be to have self-service online scheduling.

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Medical Billing Tip #2: Verify Insurance

Performing insurance verification prior to the time of service has an unquestionable impact on improving charge-to-collection ratios. Be sure to have each patient’s insurance verified a day or two before their scheduled appointment (this gives you time to reschedule the patient if you cannot verify their insurance). To verify insurance, follow one of these three methods:

  • Insurance verification by EMR or Billing Software Utilization
  • Insurance verification by Telephone
  • Insurance verification by Online Payer Resources

Designate a single employee to be your “Insurance Verification Specialist” so they can perform the task free of distraction and can quickly pick up insurance nuances in your area.


Medical Billing Tip #3: Capture Data and Measure Performance

That which gets measured, gets managed. Consistent alignment between access to information and accountability for performance measurement is the most critical factor in ensuring management of your receivables. The effectiveness of your receivables management process will always be hampered if, at any step in the process, the individuals with access to information lack accountability for performance metrics and reporting. Be sure to set measurable reporting metrics for all your relevant employees.

Medical Billing Tip #4: Collect at Time of Service

The chances of collecting on a patient decreases by 40% as soon as they leave your office. Time of service collection techniques include, but are not limited to: copays, coinsurances, projected deductibles, and collecting past due balances.

In order to optimize your opportunity for time of service collection, we suggest implementing a structured check-out process for patients, as opposed to allowing patients to ‘show themselves the door’. By formalizing your check-out process, you are creating an additional opportunity to collect before the patient leaves the building.

Medical Billing Tip #5: Utilize System Intelligence

With the ever-improving technological capabilities of Electronic Medical Records and billing software programs, many daily medical billing functions and decisions can now be automated. Many medical billing programs offer automated eligibility checking, claims edits, and charge entry.  Often, practices make the mistake of employing FTEs to handle functions that can easily be handled by their automated medical billing program.

Medical Billing Tip #6: Clean & Accurate Claims

The accuracy of the information is going out is directly related to your reimbursements coming in. Clean claims are mistake-free and can be processed without any additional information. The greater amount of claims that leave your practice clean the first time, the greater the overall health of your practice will be!


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