Three Steps To Reduce The Medical Billing Denials Your Office Sees

Collecting co-pays can sometimes be a difficult task for any physician's office, but what can really make you see red—and put you in the red financially as well—are mistakes in billing. Enough medical billing errors and your bottom dollar can be severely affected as you end up in a cycle of payment denials and refilings with corrections and additions. Here's what you should do.

1.) Track and categorize your billing denials.

Set someone in charge of tracking the billing denials you get for a set period of time, like 3 months. Any single month might be an anomaly (good or bad), but 3 months gives you a quarter of the year's sample. That should be long enough to extrapolate a couple of factors you need to know:

  • the approximate number of billing denials you receive in the year
  • the major causes behind those billing denials, by category (missing information, duplicate claims, non-coverage, etc.)

Once you have those two pieces of information, you can focus in on the right method of correcting the problem.

2.) Develop a multi-layered denial prevention method.

A lot of providers try to streamline the billing process in their office and put only one person in charge of checking the forms for billing errors before they're sent out. This is the sort of mistake that seems like a good idea at the time—because it reduces the number of hands handling the paperwork, puts accountability on someone, and likely reduces the amount of time it takes to get the claim out the door and on its way to the insurance company.

Unfortunately, that's not going to do a lot of good when the person who is responsible for the billing relies on faulty or incomplete information that was collected at the front desk because the people working patient intake don't understand billing's requirements. It's also going to create a bottleneck situation if that person becomes ill or has to take time off for any reason. 

If you focus on a team mentality, where everyone from the person working the intake counter to the person scheduling the follow-up appointment has an understanding of what the insurance company has to have in order to process the claim, you may be able to reduce errors overall.

 3. Hire a billing service.

Consider hiring a billing service like Global Health Consultants for the actual claims handling. Even a team effort is only going to do so much when the primary focus of your staff is on the patients, not the billing. A medical billing and auditing service can also help you avoid "bottleneck" problems where claims back up in the office because they all need to eventually run through one coordinating person.