Benefits of Hiring Medical Billers to Overcome 6 Medical Billing Challenges

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Effective healthcare revenue cycle management is like a seesaw, where straightening one aspect means the other rises and needs to be controlled. Healthcare providers must keep up with changing regulations and source skilled talent to ensure efficient HCRM. Still, the majority would agree that medical billing challenges are the first line that needs attention. An alarming number of issues can be resolved by hiring medical billers with updated skills and knowledge of HCRM beyond their forte. Let’s break down the 6 most common medical billing challenges and how the right talent can resolve them.

Complex Coding

Healthcare providers must realize that medical billers are only half the picture. Effective medical billing goes hand in hand with accurate medical coding. Staying updated with complex coding structures like ICD-10-CM and CPT codes is essential. Unfamiliarity with these codes can cause errors and eventual delays in medical billing. The issue is more sobering than you think; doctors lose an estimated $125 billion yearly due to poor billing practices.

Medical billers with in-depth knowledge of medical coding practices and regulations can help reduce errors and ensure accurate coding. Their collaboration with medical coding specialists is crucial to minimize mistakes and reduce claim denials, improving reimbursement chances for providers and patients. A chain reaction can start with inefficient billing, and the benefits of hiring medical billers with the right qualifications include lending their expertise to simplifying coding processes and stopping the effect of ineffective billing and coding.

Reimbursement Policies

The healthcare revenue cycle is a complex process consisting of various departments and specialists collaborating to ensure timely billing and payouts for hospitals and patients. Reimbursement may not seem like a direct medical billing challenge, but it is deeply related. Last year, some of the top concerns for hospital CEOs were revenue cycle management (52%) and Medicaid/Medicare reimbursements (61-51%).

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The nature of reimbursement processes may be complex, but the benefit of hiring skilled medical billers is their knowledge of payer contracts and diverse policies. They can navigate those processes to ensure timely reimbursements by optimizing claims submissions, eventually maximizing provider revenue. You should look for candidates who demonstrate analytical and critical thinking skills, as well as health industry insurance knowledge, so they can collaborate with insurance verification specialists to ensure accuracy and fast-track payouts.

Claim Denials

Hospital providers need steady cash flow to manage their operations properly. To maximize their revenue and invest in better care, claim submissions and timely payouts from health insurance make much difference, and medical billers play a crucial role in making that happen. Medical providers face significant delays and claim denials because of inaccurate coding and inefficient billing that seriously impacts revenue. According to HBMA, 30% of claims get denied on the first submission, indicating a breakdown in medical billing and coding practices and an immediate need for skilled medical billers.

In this case, what are the benefits of hiring medical billers with great attention to detail and technical knowledge? They can go beyond invoicing and improve resubmissions by processing claims accurately in collaboration with claims processor specialists, following the various insurance guidelines, and submitting correct claims on the first try. They should also exhibit an initiative-taking attitude to involve denial management specialists in getting to the core of denials and rectifying mistakes that cause repeated claim denials.

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Patient Eligibility Verification

Another glaring issue that creates significant delays in reimbursement processes and increases claim denials is the lack of patient eligibility verification. The high volume of claims and the amount of paperwork associated with billing, invoicing, and claim submission require proper medical billing protocols. If you don’t have medical billers who can fast-track the process and reduce errors, patient satisfaction can take a serious hit.

By collaborating with insurance verification specialists and medical staff, medical billers can avoid documentation errors, streamline patient eligibility verification by assessing patient historical data, and accurately submit claims to reduce denials. Medical billers are the first person of contact to carry the revenue cycle forward; their dedication to the process ensures that the rest of the system works just as efficiently. The benefits of hiring medical billers with diverse training and knowledge are ensuring efficient revenue cycles and greater patient satisfaction.

Fraud and Abuse

The medical industry is no stranger to lawsuits and patient dissatisfaction issues. Hundreds of people demand your care daily and must acquire medical services while managing their finances. Medical providers must be careful about preventing fraudulent activities and abuse in their billing practices that can cause revenue loss and legal repercussions.

The benefit of hiring medical billers with diverse industry experience is their ability to gauge fraudulent activities and use intuition and data to determine where fraud is committed. They can assist revenue cycle staff in identifying fraudulent activities to prevent medical providers from legal and financial losses. There are specific benefits of hiring medical billers to curb patient dissatisfaction by correctly invoicing and coding the receipts so providers would face fewer complaints and abuse from patients.

Staff Shortages

The healthcare industry has struggled with staff shortages since the Great Resignation of 2020 post-pandemic; since then, healthcare professionals, including skilled experts like medical billers and coders, have continued to exit the industry. A CWH advisors study found that 63% of medical providers faced staffing shortages in their HRCM departments. Several factors contributed to this shortage, including an aging population handling the work and exiting the industry after retiring, an onslaught of technological advancements that needed to be matched by skilled technical staff to manage, and burnout.

Addressing staff shortages can become tricky for medical providers burdened by administrative issues. In this case, there are distinct benefits of hiring medical billers from differing backgrounds and areas to address the local staff shortage. Partnering with staffing agencies can help hire the perfect medical biller with exceptional skills and industry knowledge. These agencies have vast talent pools of passive candidates that match the skill demands of medical providers and are easily scalable to meet organizational needs.

Skills and Talent Shortage in Medical Billing? Hire Medical Billers with Remote Scouts

The six common challenges listed above are becoming more significant for medical providers with the exit of competent and skilled medical billers from the industry. Even with the growth of automation and AI in medical billing, the need for human insight is ever-present. The various challenges in healthcare revenue cycle management stem from the lack of skilled talent, and medical billers are the first in line that need to be up to the mark to streamline all HRCM processes.

So, how do you ensure you find the perfect medical biller suited to your organizational needs? Remote Scouts can source, recruit, and hire expert medical billers for you. Save your recruitment time and improve HCRM cycles with untapped talent capable of handling complex billing and coding processes.

Here is how we ease hiring medical billers for you:

• We are backed by 13 years of staffing experience, which we have distilled into tailored solutions to resolve your hiring needs.
• Our expertise spans onshore, offshore, and nearshore staffing, so we can hire medical billers at competitive rates to reduce your hiring costs by 40%.
• We will place your chosen medical biller in a secure offshore but on-site facility to boost productivity and reduce overhead costs such as office placement, equipment, IT support, and onboarding.
• When looking for skilled medical billers, we tap inaccessible talent pools, leveraging the best HCRM talent available in up-and-coming markets to reduce your hiring time by 70%.
• As your Employer of Record, we go beyond hiring to provide HR functions, payroll, and compliance services to integrate and manage your chosen candidate within your company.
• We help you secure passive but ideal medical billing talent that your competitors need to learn about. This will allow you to boost your revenue and reduce patient dissatisfaction.

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