Since cash flow is critical to the success of your medical practice, it is of utmost importance to complete your billing process quickly and efficiently. This means submitting correct claims and receiving the proper reimbursement. Here are six things that you and your medical billers can do to ensure a high success rate in your medical practice:

1. Get familiar with LCDs: Ensure that your medical billers are familiar with Local Coverage Determination and their relation with specialities and billed services. By knowing about LCDs, you can understand when a Medicare carrier will cover a procedure and under what circumstance. This can help you ensure that your claims are correctly submitted and reimbursed on time.

2. Review submission reports: You can use and review your submission reports to verify if your claims were submitted and received by the payers. Since these reports will also reveal which claims were rejected and the reason why, you can steer away from potential denials and also ensure that your claims are corrected. With all the errors rectified, you can resubmit your claims.

3. Work on your denials: Both insurance companies and medical billers can make mistakes. At times a claim can be billed correctly, but the insurance company can make an error and deny it. This is why your medical billers should come up with a regular schedule in which every denial should be worked on. Also ensure to continue with regular follow-ups, until all your denials are paid.

4. Make appeals, if needed: Payers may not always follow coding guidelines, so at times, you may have to make an appeal. Take some time off to write out letters, gather the proof and submit your appeal to the insurance company. Based on your appeal, you could receive payment on your claims. Continue reading →