Clinical Documentation Plays A Crucial Role in the Revenue Cycle

Clinical documentation improvement (CDI) is becoming increasingly valuable in today’s healthcare world. CDI’s relevance is supported by AHIMA’s newly-released a CDI outpatient toolkit. This toolkit equips providers with the guidance they need to establish their own CDI system. Toolkits like this paired with professional clinical documentation improvement services help providers review their documentation processes and identify opportunities for improvement.

Clinical documentation touches all parts of the revenue cycle. No matter how skilled a facility’s staff of coders is, if the clinical documentation has gaps, the coders may end up assigning the wrong code—which will ultimately lead to a denial. Claims denials can leave millions of dollars of revenue on the table each year. Further, accurate clinical documentation not only affects providers’ back-end, but their patients as well. From the forms patients fill out at sign-in to the bill they receive at the end of their visit, any erroneous documents may lead to them paying more, misunderstanding their treatment or charges, and compromise their good relationship with the provider.

All around, providers looking to foster a healthier revenue cycle should consider partnering with expert CDI service providers. ECLAT Health Solutions’ CDI services help our clients understand weak spots in their current documentation processes and identify opportunities for improvement. We help them earn a variety of benefits for their practice:

 

The Benefits of Clinical Documentation Improvement

Perhaps the most appealing benefit of CDI services is the potential for increased revenue. In a Black Book Market Research report, hospitals with 150+ beds who outsourced CDI made over $1.5 million in revenue after hiring CDI services. This increased revenue comes, of course, from CDI specialists fixing providers’ current documentation issues, which means more accurate coding and appropriate reimbursements. Additionally, much of this revenue increase occurs because CDI specialists can also identify more efficient documentation practices to prevent future errors.

Some practices looking to implement CDI, however, may struggle to find enough already stretched-thin staff to take on CDI responsibilities. This is where partnering with a CDI company comes in. Providers who choose professional CDI services will free up many of their staff to focus on what they do best: ensure the practice keeps operating smoothly. The less staff struggling to fix documentation errors, the more staff members are available to focus on daily operations, and/or other areas that need improvement such as billing, patient care and staff communication. Naturally, these also play their part to improve revenue. However, a crucial benefit of smoother operations is less-stressed staff, fewer mistakes being made, and happier patients.

 

All in all, taking the time to implement CDI will help practices earn more revenue, enjoy fewer coding mistakes, improve patient care, and streamline daily operations. Finding the staff to do this in-house can be a challenge, making choosing a healthcare solutions company the best option for the best results. ECLAT Health Solutions helps our clients earn these benefits and more with our CDI services. Our CDI experts are skilled at identifying documentation errors and making clear, concrete suggestions to remedy these errors. We are happy to provide our clients with what we call the ECLAT Advantage which includes ongoing support, and more.

Why Choosing a Billing Company That Practices Billing Transparency is Crucial

One of the biggest issues plaguing healthcare providers is implementing the best billing practices and receiving full, on-time payment from patients. The need to improve billing practices is more important than ever, with roughly 30% of healthcare revenue being paid by patients.

Because the stakes are high, many healthcare providers turn to billing companies to handle and improve their billing and collections practices. The billing staff at ECLAT Health Solutions are dedicated to helping our clients improve their billing and collections practices to foster a healthier revenue cycle in the utmost professional manner. While many billing companies frequently call and hound customers for payment, ECLAT understands that these conversations require professionalism, discretion, and compassion. We never harass customers and strive to make paying as easy as possible for them. Furthermore, we strive to meet our clients’ financial goals and billing needs and recommend actions that will help them improve areas other than patient payment.

Allow us to provide some insight into why a transparent, cooperative relationship between a billing company and a provider is so crucial:

 

1. More On-Time, Complete Payments

With the increase of financial accountability and burden for patients, having a cooperative, transparent relationship between the billing company and healthcare provider will help boost on-time payments. Of course, patients not paying their bill on time means less revenue for a provider, but an added strain is the time and money it can take for a provider to pursue a collections battle. Therefore, when a patient does not pay on time, it is usually not viable for a facility to take legal action, and they may never see that revenue.

A billing company like ECLAT will assess the current billing and collections practices and determine where the provider can improve to ensure on-time payments to prevent these errors. For example, if a provider does not currently have staff explain a patient’s charges directly with them, this patient may feel overwhelmed by the charge or uncertain of how to pay, and therefore may pay late, if at all. A billing company can provide this crucial conversation (or train the provider’s administrative staff to do so) and help encourage patients to pay on time—and pay in full, too.

ECLAT Health Solutions is your trusted partner for ensuring your billing and collections practices translate to more on time payments. We offer EFT/ERA enrollment to our clients, and our billing staff post and reconcile ERA/EOB/Denials to the PMS every day. For collections, we offer weekly, bi-weekly, or monthly follow up to remind your patients of their outstanding payments, and always practice compassion, discretion, and professionalism in these conversations. We work to earn our clients the revenue they need while keeping their patients satisfied and coming back for any necessary future treatments.

Read our post “3 Medical Billing Best Practices for Receiving More On-Time Payments” for payment collection tips.

 

2. Improved Billing Practices

Transparency between a billing company and provider is necessary for improving the provider’s end-to-end billing practices and revenue cycle, even beyond increasing the rate of on-time payments. Providers must have accessibility and accountability for their practice and partnering with a billing company can establish this. Having a secondary set of experts review their medical coding practices translates not only to increased revenue from patient payments but more efficient, accurate processes that lead to fewer costly mistakes.

ECLAT Health Solutions billing expert Dorothy Lodato, who has years of experience with medical billing, stated, “In many cases, a provider’s in-house staff receives payment regardless of how much money is collected from patients, while a billing company gets paid a percent of the money collected.” Therefore, it is mutually beneficial for billing companies to be transparent with their clients and offer effective suggestions for improvement; the provider receives the revenue they need from patients, and so does the billing staff.

We work on a personal level with our clients to determine what is currently missing from their billing and collections processes. Our clients’ billing goals become our billing goals, and we always hold open communication with our clients to determine opportunities for improvement.

 

When it comes to improving billing practices, it is crucial that providers choose the right billing company for the job. Providers must partner with a billing company that promotes cooperation and transparency to best foster a healthy revenue cycle and see an increase of payments. ECLAT Health Solutions’ medical billing experts specialize in helping our clients remedy their current billing issues and take advantage of opportunities for improvement. Our open collaboration with our partners allows us to get to know their practice and meet their billing goals.

Improving Patient Experience Can Improve Your Revenue Cycle

As RCM professionals, ECLAT Health Solutions knows that earning a healthy revenue cycle doesn’t just stop at medical coding and billing. The key for facilities to reach their maximum revenue potential is to marry excellent patient care with their revenue cycle management. Here, we delve into why improving patient experience practices is so crucial. Between medical coding, claims submissions, billing, and all the other moving parts that make up the revenue cycle to focus on, the last place some providers look when attempting to improve their revenue cycle is patient experience. They may view their patient care and customer service practices as a second-tier need without realizing just how much it matters for their revenue cycle; therefore, their practice continues to miss out on revenue opportunities. On the contrary, the experience a patient has at a hospital or doctor’s office can play a huge role in revenue.

Accenture conducted a study and found that there is a high correlation between excellent patient care and increased revenue in hospitals. The study found that hospitals that provided superior patient care enjoyed an average of 50% increased revenue. Such a high increase is certainly worth taking note of, especially for facilities struggling to identify the causes of depleted revenue.

 

Why Patient Care Matters:

The best patient care goes beyond simply signing a new patient, providing treatment, and collecting payment. Every single interaction a patient has with a facility contributes to the patient experience. There are several opportunities throughout the patient-provider relationship for the patient to affect revenue flow – for better or for worse.

From the moment a potential patient first picks up the phone and contacts a provider to make an appointment, the provider must be prepared to provide excellent customer service. As with any business, these early interactions establish the patient’s perception of the provider and will play a huge role in whether they become a patient—and, therefore, bring in more revenue. Even further, after an individual has officially become a patient and received treatment, ensuring their needs are met and providing excellent service is key for determining if they will remain a loyal, satisfied, and paying patient, or if they will look elsewhere for future treatments.

The patient experience does not necessarily begin the first time a patient contacts a facility directly. Patients who are looking for standard, non-emergency care will conduct online research and read several reviews for a physician before reaching out for an appointment. Advisory Board reported that in a study of 2,000 patients, almost 70% of them looked at online reviews before choosing a physician’s office. Potential patients use previous patients’ experiences to determine if they will choose a provider or move on. Therefore, giving all patients superior care and customer service has an impact on future patients, too, making it crucial that facilities and providers assess their current practices and provide the best care possible.

 

At ECLAT, our expertise in medical coding, medical billing, ICD-10 auditing and CDI services  like DRG-mismatches or working DRGs, helps our clients earn more revenue by allowing providers to dedicate more of their invaluable time to building relationships with their patients, thus improving patient care. Bottom line – combining superior customer service for patients with effective RCM is the best way for facilities to vastly improve their margins.

4 Places to Look for Missing Revenue

Hospitals and other providers miss out on millions of dollars of revenue each year due to inefficient RCM practices. Between administration, billing, and coding, there are a lot of moving parts that, when working together, foster a healthy revenue cycle. However, this also means that when best practices are not used, or mistakes are made in any of these areas, revenue can be lost and may not always be easily or immediately detected.

For hospitals and providers that don’t love their bottom line, there are a few places they can look to track down that missing revenue. As medical coding, billing, and auditing experts, we are skilled at helping our clients and partners understand why they are missing out on crucial revenue, and how to recover it. With accurate coding, efficient billing, and expert clinical documentation improvement (CDI), we offer a variety of services that improve our clients’ revenue. We work as an extension of our clients’ practices, which allows us to explore and assess RCM errors on a deeper level.

Here, we provide insight into where facilities should look for missing revenue:

 

1. Clinical Documentation

Providers who struggle to identify the root cause of missing revenue should assess their clinical documentation processes. Every piece of clinical documentation must be as accurate, descriptive, and comprehensive as possible to ensure proper reimbursement. When a provider fills out patient documents, they must describe the patient’s condition and requested treatment as accurately and thoroughly as possible. This description is used by coding staff to assign the proper ICD-10 code and process Medicare DRG or MS-DRG claims. Inaccurate documentation will lead to inaccurate code which, of course, leads to claim denials and delayed reimbursement.

ECLAT now offers clinical documentation improvement (CDI) services that ensure our clients do not miss out on revenue opportunities. We provide our clients with detailed, thorough feedback on their current documentation processes as well as concrete steps and solutions for improvement. We work closely with hospital CDI teams to generate the most accurate codes and DRGs, which translates to successful on-time reimbursement and increased revenue.

 

2. Patient Experience

When looking at their RCM practices and assessing how to improve, many facilities fail to factor patient experience into the equation. However, the experience a patient has at a facility, from signing in, to receiving their treatment, to paying their bill and everything in between can all affect incoming revenue. High-quality patient experience was proven to greatly improve hospital revenue in one study conducted by Accenture. Providing superior customer service to patients affects their perception of a facility and will play a role in whether they return or seek out other providers for their next treatment. Further, a facility that offers transparent billing options and practices through their billing staff’s interactions with patients is likely to increase on-time payments. We discuss this a little further in the next section.

 

3. Billing & Collections Processes

Many healthcare facilities can find causes of missed revenue in their billing department. One common billing error comes from failing to collect payments at point-of-service. Availity conducted a study and discovered that a surprising number of facilities do not enforce POS collections and therefore either receive delayed payments or no payments at all, negatively affecting the health of their revenue cycle. In addition, facilities that do not take the necessary steps to communicate openly with patients and ensuring they understand their medical bill are more likely to suffer delayed payments. In the day-to-day of a busy physician’s office, simply handing a patient a bill is easy and convenient, but a patient who does not thoroughly understand their charge and how to make payments likely will not make them. For facilities with lower revenue, a deep look into current billing practices may provide some answers.

 

4. Quality Assurance Processes

Quality assurance is crucial for ensuring facilities maintain a healthy revenue flow. Using quality assurance processes will help a facility identify and avoid common causes of RCM mistakes such as coding errors, patient coverage inaccuracies, administrative errors, and claim denials before they can contribute to diminished revenue. Even further, quality assurance will allow a provider to identify patterns of errors in their revenue cycle and learn to avoid them in the future. ECLAT performs a 3-tier quality assurance process for each client to ensure accuracy and excellence at every step of the way. We perform this process with a 24-hour turnaround time for each case to give our clients the tools they need to earn and maintain higher revenue. Providers suffering decreased revenue should closely review their current quality assurance processes and search for ways to improve and earn better revenue flow.

 

At ECLAT, our medical coding and billing experts provide our clients with accurate, efficient services that help them improve their bottom lines. Not only do we identify causes of our clients’ missed revenue opportunities, but we provide suggestions and resources for helping them improve. Our comprehensive medical coding, billing, and CDI services all work to ensure our clients earn the highest revenue possible. We have found that facilities that take a deeper look at their current quality assurance, coding, and patient experience processes earn more revenue and a healthier revenue cycle.

Why Your Facility Should Check Claims Daily

Claims denials are a big reason why many healthcare providers miss out on annual revenue, making it crucial that you closely monitor your claims process every day. Perhaps your facility does one large, overarching review of all claims submitted in a certain period, such as every week or even every month. This review of multiple claims at once can provide useful data and insight into how several claims affect your bottom line.

However, only checking individual claims as they are processed and conducting a daily review of all claims submitted in that day will ensure your facility gives the claims process the close, analytical attention it requires for earning a healthier revenue cycle. Establishing a daily claim-checking process will give your billing staff a better bird’s-eye view and understanding of your own claims submissions and reimbursement process.

Not only will a thorough daily review help catch claims denials, but it will help your facility notice patterns of why claims are being denied or reimbursements are often delayed. Although your facility may work on processing one claim at a time to ensure each individual claim is accurate, this can actually cause your employees to miss out on overarching trends within the claims process, and therefore repeat the same mistakes.

 

What Should Be Part of Your Claims-Checking Process?

Your facility’s daily checks should involve reviewing every step of the claims life cycle, including:

 

1. Checking Patient Insurance Eligibility:

Your claims-checking process should begin even before a claim is made! Your administrative and billing staff should check every patient’s insurance coverage prior to providing service. Many claims are denied due to discovering that a client doesn’t have the insurance necessary to cover the treatment provided. If your facility has not always checked patient eligibility before service—or at all—you must make this part of your daily practices. For more information about the importance of checking patient eligibility, check out our last blog.

 

2. Submitting Claims:

Before submitting a claim, of course, your staff should double check the claim’s information. This pre-emptive check will ensure your staff catches any mistakes and makes necessary edits. Does the patient in question’s insurance coverage line up with what is recorded in the claim? Does the given treatment have the proper ICD-10 code associated with it? Although it can be easy for double-checking to fall by the wayside in a busy medical office, taking the extra few minutes to review a claim prior to submission can mean all the difference between an easy, quick reimbursement and a costly denial.

 

3. Re-Submitting Claims:

When a claim is denied and must be resubmitted, your staff must first look into why the denial occurred before making edits. A claim re-submitted without investigating the cause for the denial may be incorrectly edited and therefore denied again. Without proper follow-up, your staff may misidentify the reason for the denial, or fail to realize there were multiple denial causes. Checking the cause of each denial as they occur will not only prevent the claim from being denied a second time, but also provide your staff valuable insight into common reasons for claim denials over time.

 

Improve Your Claims Process With ECLAT

With ECLAT Health Solutions, your billing goals become our billing goals. Our medical billing experts look closely at every step of your claims process to ensure that your practice sees less claim denials and more revenue. We work as an extension of your facility, and provide individual, customized attention that our clients call “The ECLAT Advantage”.

Partner with a company that will help your facility earn a healthier claims process. Contact ECLAT today to learn more about our medical billing services!

Common Revenue Cycle Errors You Can Avoid by Checking Patient Eligibility Prior to Service

The concept of checking a patient’s insurance coverage and eligibility prior to providing a service certainly seems like a straightforward, best practice. However, a study conducted by Capario reported that a shocking number of practices do not check patient insurance coverage before service, or at all. The study found that one-quarter of the facilities studied did not check patient eligibility until after the patient received treatment, and an additional one-quarter did not check eligibility at all.

These results are concerning, as failing to check patient eligibility can cause a variety of RCM complications, which subtracts from your facility’s revenue. If your practice is like many other practices in the United States, you are likely unable to afford several costly RCM mistakes. Checking patient eligibility before service can help you avoid the below RCM errors:

 

Reducing Claims Denials

Practices who do not check patient insurance coverage before providing treatment and submitting a claim are likely to have the claims denied if the patient’s eligibility does not line up with what is recorded on the claim. Claims denials can be very costly and difficult to remedy and resubmit, so checking coverage prior to service can prevent claims denials and delayed claim payments. If your facility provides treatment and submits a claim without checking your patient’s coverage, then find later on that a patient was not covered, the claim will likely be denied. To help prevent this, train your staff to verify patient eligibility before submitting a claim and to investigate the causes of claim denials when they do occur.

 

Inaccurate Billing

Checking patient insurance eligibility before service is crucial for ensuring accurate billing data. Not checking eligibility causes billing problems for both your facility and your patients. For patients, not checking eligibility could lead to a patient being overcharged (or undercharged) for their treatment. If your front office staff provides treatment without checking insurance coverage, then later discovers the patient is not covered for the treatment, this may result in your facility paying more or a higher bill for the patient than was expected. Similarly, without verifying the correct insurance information, your patient may end up paying a higher or lower copay than necessary.

 

Missing or Late Payments

To take the potential billing complications even further, if your patient is not charged properly and winds up having to pay more out of pocket, they may not pay on time, especially if they do not understand why they have been charged more. Your staff should be trained to identify patients who may try to avoid paying on time and help hold open communication about the billing process and payment options. Learn more payment tips here.

 

Experience Medical Billing Brilliance with ECLAT

ECLAT Health Solutions offers medical billing solutions to help our clients improve their billing processes and earn more revenue. Our medical billing experts on average have over 10 years of experience and always maintain HIPAA and HITECH compliance to ensure your practice’s billing information stays secure. We work as an extension of your practice to walk you through your billing process.

Only ECLAT meets with you face-to-face to not only process your claims but also identify and fix billing errors.

When you partner with ECLAT, you can be sure that verifying patient eligibility will become part of your regular billing processes to help ensure that your practice earns as much revenue as possible.

Contact ECLAT today to get started!

Practicing Point-of-Service Collections Can Improve Your Revenue Cycle

In today’s healthcare climate, with shifting healthcare regulations and high-deductible healthcare plans, more and more patients have to make out-of-pocket payments to receive treatment. For physicians, hospitals, and other facilities that do not always require patients to pay while signing in for an appointment, tracking down patients after providing care can be a complicated issue for many healthcare providers. This hurts a facility’s revenue cycle, which can mean millions of dollars of missed revenue every year.

Collecting payment prior to providing service seems straightforward in theory, but it is not being put into practice by many providers. A report by Availity found that although more than 90% of their 500+ surveyed providers (over 300 physician practices and 200 hospitals) claimed that enforcing point-of-service collections is crucial for their revenue, an alarmingly small portion of those providers actually collect payments before or at the time of service. The surveyed physician practices reported only collecting about 35% of POS payments, and the surveyed hospitals reported only 19% of POS collections.

Enforcing POS collections is key for fostering a healthier revenue cycle and earning a more favorable bottom line. Engaging with patients in-office at the time of service helps increase the chance of your practice receiving payment in a timely manner, or at all. When a patient pays for their treatment in full before receiving it, this immediate collection eliminates the need to follow up with that patient later on, which saves your staff time and ensures your facility receives the revenue it requires.

Defining expectations for payment at the point of service helps educate the patient about what they owe and increases the likelihood that they will pay. Even if a patient cannot pay their bill in full at the time of their visit, requiring POS collections ensures that at least part of the bill will be paid and gives the patient the opportunity to sign up for financing options at that time if needed. Further, this puts less stress on the patient and helps improve their patient experience.

 

Tips for Improving POS Collections:

Enforcing POS collections can overall improve your facility’s bottom line. As medical billing experts, we always utilize billing best practices to ensure your facility earns the revenue it requires. Here are our suggestions for enforcing POS collections:

  • Re-train your staff to require patients to pay while signing in before service, or while finishing up their appointment
  • Always have a staff member manning the front desk or the location where patients make their payments. A common reason POS payments do not occur is that busy staff don’t catch when patients leave without paying.
  • Promote billing transparency and open communication with the patient. Your practice may benefit from hiring a staff member who is dedicated to reviewing payment details and requirements with patients to ensure transparency. A patient that understands what they owe and how to pay for it is more likely to pay.

Read more about how to increase POS and on-time payments in our post, “3 Medical Billing Best Practices for Receiving More On-Time Payments”.

 

Experience Billing Brilliance with ECLAT

ECLAT Health Solutions offers medical billing services that can help your practice earn a healthier revenue cycle and increase your rate of patient payments. ECLAT meets with you face-to-face to discuss your billing practices and remedy any errors that we identify. We can work on almost any EHR, and we always maintain HIPAA and HITECH compliance. We make your revenue goals our revenue goals, and provide customized billing solutions that will work toward accomplishing these goals.

Contact us today to learn how to enforce POS Collections in your practice!

Benefits of Offshore Medical Coding for Your Domestic Staff

More and more healthcare providers are utilizing offshore medical coding and are enjoying a variety of benefits. One of the biggest appeals of offshore medical coding for many providers is the bottom line – hiring overseas coders is more cost-effective than searching for employees at home. This is a huge asset for providers, but it certainly is not the only one. Financial incentives aside, outsourced medical coding also has several benefits for a facility’s domestic staff. Below, we explore some of the ways that offshore coding can benefit your domestic employees.

 

Freedom to Focus on the Administrative Side

Outsourcing your medical coding practices leaves your domestic employees with more time and resources that they can put toward bolstering and reworking other areas of your facility that need help, such as your administrative tasks. Refining the administrative side can help improve your facility’s billing and collections practices, patient experience, and claims submissions process, all of which will help increase efficiency and foster a healthier revenue cycle. Any staff who may have been doubling as coders or assisting with coding processes will now be free to focus on their main roles and responsibilities.

 

No Need to Re-Train Domestic Employees

Healthcare providers that feel their domestic employees’ lack of training has affected their efficiency or revenue may dread the effort, money, and resources that they will need to put into retraining them. Offshore coders are joining the workforce with the same qualifications, skills, and training as new coders in the United States at a reduced cost, making them capable of providing accurate medical coding and maintaining security. When providers look overseas for their coding solutions, they eliminate the need to spend valuable funds on training programs for their domestic staff. Offshore coders will need to receive some training to become familiarized with your facility’s best practices and procedures, but this is minimal and spares your facility the cost of a complete training overhaul that your domestic employees may need. No re-training for domestic employees also saves them time and stress, and allows them to focus on other, more important tasks and processes.

 

Fewer Errors and Less Stress

Using skilled offshore coders for your medical coding needs can help drastically reduce medical coding errors. In some facilities—often small or understaffed ones—busy staff may be prone to making coding errors, especially if these domestic staff are new to the workforce or have been struggling with the switch to ICD-10. Highly trained outsourced coders will likely make fewer errors, which means the rest of your staff will not need to scramble to fix mistakes such as claims denials. Often, the stress involved with fixing errors can actually lead to more mistakes being made, which compromises the health of your revenue cycle.

To earn the benefits of offshore medical coding, both for your finances and your staff, partner with an expert international medical coding company!

 

Offshore Medical Coding – The ECLAT Difference

ECLAT Health Solution’s team of outsourced medical coding experts are highly trained in ICD-10 coding procedures and are trained to maintain HIPAA and HITECH compliance. Not only is our coding secure and accurate, but our 3-Tiered Quality Assurance Process ensures we deliver superior work every step of the way. During this process, we closely analyze and review any cases that our coding team have questions on and prevent or fix errors. We go above and beyond to help your practice enjoy a healthy revenue cycle and increased revenue with our 24-hour turnaround and holiday and weekend coverage at no additional cost.

Contact ECLAT today to learn more about our offshore medical coding services.

3 Medical Billing Best Practices for Receiving More On-Time Payments

Missing or late patient payments is one of the biggest problems facing medical practices today. The disconnect between providing a treatment and receiving payment may happen for a variety of reasons, either on the side of the healthcare provider or the patient themselves. Although healthcare providers can only do so much to ensure a patient ultimately pays his or her medical bill, making internal improvements to medical billing practices can help increase the rate of on-time payments. Here are 3 medical billing best practices your facility can use to boost patient payments:

 

Focus on Point-of-Service Collections

Requiring payment in-office directly after providing a patient with treatment seems like a straight-forward concept, but a recent study by Availity found that many providers collect only a small amount of patient fees at point-of-service. The study reported that physician practices collected only 35% of patient fees and hospitals collected only 19% of patient fees at or before service. These providers overwhelmingly agreed that it becomes increasingly difficult to collect payment later after treatment has been given.

There are a few reasons that point-of-service payments may not be collected. At many facilities, front office staff waits until after a patient is seen to collect co-pays or other required payments. In addition, busy office staff often get sidetracked and don’t see a patient walk out of the office without paying.

If your facility has a low rate of on-time payments, put priority on collecting payments at point-of-service. Train your administrative staff to require that all patients pay their copay as they sign in on the day of service. Have your staff follow up with any patients who do not or cannot pay in-office. Enforcing at least partial payment for the treatment immediately following service is another key method to increasing patient accountability and receiving more on-time payments.

Train your staff to be wary of and identify “dead beat” patients who will never end up paying their bill. Although clients may receive one or two collection letters, many patients are aware that pursuing legal action is too costly for the collection agency, and intend on ignoring all warnings. Your staff should closely follow up with these kinds of patients and offer a variety of solutions to try and encourage payment.

 

Communicate with Patients Proactively

With medical bills and the amount of out-of-pocket patient payments increasing over the years, paying medical bills can be an overwhelming and confusing process for many patients. For higher frequency of on-time payments, your administrative and billing staff should not simply hand patients a bill and send them on their way. Have your billing staff sit down with a patient and explain their charges, as well as review the available payment options. Many patients simply do not understand their bill or how best to pay, and opening direct communication can mean all the difference between an on-time payment and a drawn-out collections battle.

 

Keep Accurate Records

Some hospitals who suffer from high rates of late patient payments do not have good record-keeping practices in place. Your administrative staff should keep track of how much each patient pays and how often. Without up-to-date records, your administrative staff may not even know a patient is behind on payment or that a bill has been paid in full. If you’ve noticed multiple billing errors and/or past due payments, try giving your record-keeping an update.

Improve Your Medical Billing Processes With ECLAT

ECLAT Health Solutions, a health services support provider, can drastically help you increase your rate of on-time payments with our medical billing services. No Billing service meets with you face-to-face to walk you through your billing issues. ECLAT does.

Not only do our billing experts process your claims, but we work to identify and remedy any errors in your billing processes.

Our billers have at least 10 years of experience and are trained to comply with all HIPAA and HITECH, CMS guidelines, and In-Network, Out-of-Network regulations. We are EHR-friendly, meaning we are versatile to work on any EHR,and keep meticulous records of your payment records to ensure you can easily keep track of your various patients’ payments. With ECLAT, you will start to see increased revenue quickly, with a 15-day turnaround time.

Our Eligibility & Benefit Verification process helps your patients understand their bill and their payment options to increase patient accountability. We understand that one size does not fit all, which is why we offer customized billing options and services for our clients and their patients. We work as an extension of your practice, providing you with secure and accurate medical billing so you can focus on what you do best: provide quality healthcare.

To learn more about our medical billing services and best practices, contact us today!

4 Tips for Reducing Claim Denials

Claim denials are a nuisance for hospitals and other healthcare facilities, and can end up costing millions of dollars in revenue every year. There are, unfortunately, many reasons that a claim may be denied, with anything from a patient simply not having the proper coverage to a coder using the wrong ICD-10 code, and everything in between. Fixing and resubmitting a claim can cost more money and give your staff additional paperwork to work through—in other words, no good comes from a high number of claim denials.

Although it is not likely that you will completely eliminate all claim denials, most claim denials are preventable. It’s crucial that you take the measures you can to reduce claim denials and save valuable revenue. Below are some of our tips for reducing the number of claim denials at your facility.

 

  1. Improve Employee Training

Undertrained staff can create a myriad of problems for your hospital or facility, and claim denials is one of the most common of these. If your medical coders are not properly trained in ICD-10 procedures or your billing staff continues to make clerical errors, it may be time to take another look at your training procedures. Tweak and refine your process, and retrain current staff if necessary. Make sure your employees are being properly managed, too, with clear policies and best practices in place.

 

  1. Look for Patterns

Make sure your employees are closely monitoring every step of the claims process, so they can identify any issues that happen over and over again. Investigate why a claim gets denied immediately at the time of denial; it is much more difficult to look back at the claim later and find out what went wrong. When your staff keeps an eye on the claims process and immediately follows up with denied claims to determine the cause, they will be able to spot common patterns and learn how to put an end to them much faster.

 

  1. Check Patient Coverage Before Treatment

It seems too obvious to say that checking to make sure your patients’ insurance covers the necessary treatment prior to giving this treatment can reduce your facility’s number of claim denials, and yet a whopping number of healthcare providers fail to check patients’ insurance before providing service, or at all! Ensure your administrative employees are checking each new patient’s insurance to find what they are or are not covered for. Routinely doing this will help prevent any surprises after submitting the claim.

 

  1. Improve Medical Coding Practices

Entering a similar yet incorrect code for a given treatment, or having incomplete documentation that leads to an unspecified code can cause a claim to be denied. Some coders are still catching up to the 2015 transition to ICD-10, and are still making mistakes. Unfortunately, there is no room for mistakes on a claim, and a coding error will most likely lead to the claim getting denied. Your coding processes should be air-tight to ensure your claims will be accepted. An excellent way to improve your medical coding accuracy is to partner with an expert healthcare support provider.

 

The ECLAT Advantage

ECLAT Health Solutions provides outsourced medical coding services nationwide. We provide 24-hour turnaround and can guarantee a score of 95% or higher coding accuracy, making us the key to helping your facility reduce its claim denials. Our satisfied customers—which include hospitals large and small, physician offices, ambulatory surgery centers, and much more—call our ability to go above-and-beyond with our service The ECLAT Advantage.

Contact us today by filling out this form or calling (703) 665-4499 to learn more about our medical coding services.