All Medical Billing

8 Ways How Practolytics Can Improve Your Medical Claims Billing Process in 2022?

Running a practice is not easy and there are many aspects that need your attention. More often than not, these aspects can become too much for you to handle and take your valuable time away from your patients. Having your own practice should not do that to you, and you should be able to focus on providing excellent healthcare to your patients.

However, the success of your practice is not just dependent on the healthcare you provide to your patients but also on the revenue and profits you make. Without enough revenue, you cannot invest back into healthcare, meaning that you cannot afford the technology required for the excellent care of your patients. Or you may not be able to hire well-trained staff to take care of these patients during their visit. Needless to say, it is crucial that you have a good revenue collection system to maintain your practice.

Since the revenue from your practice mostly comes from the claims and billing procedures, it is absolutely important that your staff is able to manage these processes, without any errors. Although it is human to err, mistakes made during claims processing could result in denials. Each denial can cost your service up to $45. These costs can add up over time and result in a net loss of revenue for your practice.

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When Should You Decide to Partner Up With Practolytics?

Practolytics is the partner of choice when it comes to medical billing of private practices in the healthcare industry. We provide a medical billing service that takes the stress off of your plate while streamlining the process, resulting in a net increase in revenue.

The decision to partner up with Practolytics has to be an efficient stress-reliever for you and your staff. It is recommended that you partner with Practolytics if you are struggling with your medical claims and billing process. To ensure that the billing process is performed accurately, you have to either hire trained staff or train your staff to go through each step of the process with increased efficiency. This can be quite costly for your practice, and even with trained staff, there are chances of errors that can have a negative effect on your practice. After all, it is human to err and they can’t be penalized for that. The easiest solution would be to outsource this process to the professionals, such as Practolytics.

Letting professionals handle the medical claims billing process may be the best choice especially if you are noticing a pattern of denials, arising from incomplete claim submission or wrong patient information or even, from sending the right patient information to the wrong payer. These are often present in practices that are falling behind on the medical claims billing process and internal fixing of this problem is not as easy as one would believe. Changes need to be made at multiple levels and a significant amount of manpower and hours need to be invested to prevent these problems from occurring. However, partnering with Practolytics solves the issue at hand with increased efficiency and allows your staff to have more time to dedicate to the patients in the clinic. They are less worked up from the paperwork and will more likely be relaxed and friendlier in the clinics.

Another reason private practices fall behind on medical claims billing and revenue collection is that they cannot keep up with the new rules and regulations. Being unaware of these means that you cannot update your applications accordingly, resulting in increased denials. Moreover, not keeping up with these regulations during the COVID-19 pandemic can be significantly detrimental to your practices’ profits. There have been many changes in medicine during this pandemic, the main one being the introduction of telemedicine. Insurance providers have changed their policies related to the coverage of this new branch of medicine, and not knowing these is not recommended. Practolytics keeps track of all information and policies related to the patient and the payer, hence, keeping your billing process up-to-date.

Simply put, if your practice is lagging behind on the claims and billing process, regardless of the reason, it may be highly beneficial to partner with Practolytics.

Benefits of Partnering with Practolytics

Practolytics simply streamlines the medical claims billing process by not only getting involved after the appointment is over but rather from the moment the appointment is scheduled. This way, every step of the process is accounted for and the chances of an error occurring are minimal to almost zero.

Keeps Patient Files Updated

Practolytics ensures that the patient files are kept up-to-date, with updates recommended at the time of appointment scheduling. This way, any change in their insurance plans can be accounted for at the time of appointment. Practolytics prides itself on zero errors made during the billing process and they start doing so by updating patient files. If this were not done, the claim would most likely be made to the wrong payer, hence, delaying your billing process. Practolytics stays on top of patient information, and the service they provide is completely HIPAA compliant. Moreover, doing this allows there to be proper insurance eligibility prior to the appointment.

Pre-authorization

Practolytics takes care of preauthorization for your scheduled patients so that the revenue cycle management can be streamlined and result in maximal revenue within a short period of time.

Insurance Eligibility Verification

You should be doing this in your service, and it is a task that requires dedicated staff members to spend time and effort recognizing if the patient has an insurance plan that covers their visit. Practolytics can also take care of that for you. We perform eligibility verification and this is crucial because if a patient isn’t eligible, they should be informed beforehand. This allows the patient to be aware and not be surprised during the appointment when they are expected to pay. If patients are surprised with their lack of insurance eligibility during the appointment, they may not be able to pay and the billing process may delay collections further.

Accurate Medical Coding

Medical coding is the process through which billing information is extracted from the medical records of the patient, which is then transferred to insurance payers in the form of codes or shorthands. Making a mistake during this step by using the wrong medical code will result in denial. You will then have to repeat the whole process which is quite tedious and takes a lot of time. Not to mention, each denial will cost your practice anywhere between $15 to $45. Practolytics ensures all patient records are coded to the highest level of accuracy to ensure there are no errors during claims submission.

Tracking and Eliminating Denials

Denials are the biggest enemy of your revenue and it is key that you manage them properly in your service. It is not only important to ensure that denials do not occur and hence, eliminate them, but it is also crucial for you to dispute denials when you believe there is no valid reason behind a denial. In most cases, disputing the denial resolves the problem and you don’t have to make the claim again. Practolytics takes care of the billing process and ensures that no error occurs during the process that could potentially result in denials. Moreover, they actively track denials and dispute them on your behalf, to avoid wasting any time if a mistake is made by the payer.

Improved Claim Tracking

Practolytics follows up on every claim made to the payer regularly, to ensure timely payouts. No claims are lost through the cracks. The claim tracking services of Practolytics are especially helpful in following up on delinquent claims that haven’t been paid. Usually, you would have to have a staff member spend their time specifically following up on these, probably long after they were due. With professional help, these claims don’t get lost among the others and are tracked actively to increase revenue management.

Management of Accounts Receivable

Practolytics has the technology to manage your practice’s accounts receivable or AR days. This basically refers to the number of days your practice’s medical bills stay outstanding before being paid. For the success of your practice, it is crucial that this is managed and the number of AR days is low, especially if you want to avoid involving collection agencies. Practolytics ensures proper management of AR days so that collection agencies are never needed.

RCM solutions

Apart from the specific tasks that Practolytics performs for your practice, they are excellent at the management of your revenue cycle in general, meaning that they facilitate the entire process. They reduce significant stress and potential money loss from your revenue cycle and give you the time you need to focus on your patients’ healthcare.