How to Optimize Reimbursement Rates Through Automation

In today’s medical industry, it is becoming incredibly challenging to ensure all the processes within medical billing and reimbursement are being met and thoroughly vetted. With multiple processes like insurance contract terms, payment policies, and billing issues needing proper attention, you must be on top of your game and develop a strategy and a system that can streamline it for you.

One of the most pressing issues within medical billing and insurance processing is to determine and properly deliver reimbursement rates. For each claim that is submitted for reimbursement, there is a great responsibility upon medical officers to ensure they are rightfully processed.

With the amount of attention required to ensure all processes are running properly, digitizing your system, and using automation to streamline the process is almost mandatory. This need has prompted most medical office managers to migrate their systems to cloud-based, secure software that can easily optimize these processes and ensure proper transparency for each step of medical billing.

The Role of Automation in Medical Billing

Like any other taxing process, medical billing requires a lot of attention and focus to get right. When sifting through patient data, even the most minor details can throw a wrench in how their payments are processed and that can affect reimbursement. To fast-track this entire process, you can automate your billing system which can directly impact Medicare reimbursement rates.

You need to know some key elements to properly automate your billing system:

• Your patient data, including their history, their visit schedules, and all the information needed to file their case.
• The diagnosis for each patient is the most important information that must be properly stored. You need to know their process codes and have a proper system to retrieve their diagnoses whenever needed.
• Each patient that is logged into the system has a specific fee schedule. It is important to know the fee schedule to ensure you know when and how each payment is to be made.

Now that you know the main things you need to have in place for automation, it is also advisable to know why automation is necessary. There are multiple challenges that arise during medical billing that are the direct cause of manual processing errors and uncoordinated billing systems. Opting for automation will give you the following benefits:

1.  Accurate Billing – you will be able to properly streamline the claims billing process and avoid having to trudge through mounds of data every time, which will save time and money.
2. Reduced Human Errors – of course, a recurring challenge you will face in billing is human error which can create long-standing issues, especially when processing patient information. The reduction of human errors from data input will create fewer mistakes.
3. Improved Efficiency – you can imagine that every process can benefit from automation, but it can most effectively streamline payment options for patients. Customers can find multiple ways to pay online and that helps medical teams to focus on their core tasks without having to manage manual payments.
4. Speed Up Reimbursements – the most important part of a billing system is to ensure your reimbursements are going out on time and being received successfully by your patients. By reducing processing errors, an automated system can quickly process claims and eliminate delays due to manual data entry issues.

5 Automation Pieces to Submit Correctly to Boost Revenue Recovery

Now that we’ve reviewed the basic processes that can benefit from automation, let’s look at a few automation pieces your office can submit that can enhance your revenue recovery to help improve your accuracy as well as efficiency. There are a few correct ways that automation can help expedite the billing process.

1) Correct Patient Information

In order to receive timely payments, you need to ensure that the right information is submitted the first time to avoid any issues after that. This is where automation comes in. It reviews your information to make sure it’s correct and then submits it electronically. This process reduces manual entry errors in coding and billing, resulting in faster processing.

Now what are some of the ways that you can automate your data input and ensure your information is correct and processed duly within a shorter time frame? Look at these 7 ways to automate your data input and increase accuracy:

1. Automated patient intake improves patient satisfaction and reduces staff workload.
2. Automation can give you ready access to patients’ information.
3. Data capture software collects information in invoices and transforms them into electronic formats to improve billing accuracy.
4. You can automate simple tasks like scheduling appointments, claims, and billing so that medical staff focuses on patient care instead of data entry.
5. Automation can verify that documents are correct at the point of care or admission. This reduces errors and improves the patient’s experience.
6. Robotic process automation (RPA) technology automates data entry, so physicians can focus on patient care rather than paperwork or administrative tasks. This is an incredible asset that can be utilized to ensure the best care is provided to patients.
7. Automation leverages artificial intelligence (AI) technologies to efficiently review data, helping healthcare providers make better decisions about treatments, diagnoses, and other important patient care decisions.

2) Correct Diagnosis Codes

Correct diagnosis codes are key when you submit medical invoices for reimbursement. They are based on the International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes.

The ICD category describes a patient’s diagnosis, while a CPT describes the healthcare provider’s services. Both codes can and should be utilized for accurate claims. Knowing which to use streamlines

the billing process for prompt payment. Now here of the ways that automation can improve diagnosis code submissions:

1. It reduces human-related mistakes and increases accurate claims by submitting the correct diagnosis codes.
2. It identifies billing errors before a claim is submitted, leading to quicker payments, and avoiding delays or incorrect submissions.
3. It tracks patients’ billing data, making it easier to submit the correct diagnosis codes.
4. Automation enables quick submission and tracking of payment requests, including accurate diagnosis codes.
5. Automation allows patients a digital mobile experience by submitting payments via their mobile phones. This increased mobility enhances their customer experience and builds trust in the medical billing processes.
6. By automating diagnosis codes, the staff is free to focus on core tasks that require actual human interventions.
7. Automation of diagnosis codes with fast data entry results in fewer rejected payments due to incorrect information. This is an apparent win for medical reimbursement rates.

3) Correct Fees

Automation stores, updates, and tracks medical billing fees and integrates with electronic health records systems to submit the correct claim fees. Additionally, your office will save time by reducing the number of times your staff enters data. There are specific benefits to automating the tracking of your billing fees, an otherwise tedious process that is prone to mistakes and oversight. Here are 5 benefits to automating the billing fees for faster reimbursement:

• Improved Accuracy: You will be able to reduce errors by avoiding multiple manual data entries for accurately billed fees.
• Increased Speed: The processing of faster claims will reduce wait times for reimbursements and generate positive feedback from patients.
• Reduced Costs: Under any circumstance, automation of the billing process cuts down on the manual labor costs that will otherwise be incurred.
• Improved Compliance: It is important that all billing processes are met with compliance standards to avoid any litigation or disputes in the future.
• Enhanced Customer Service: In the medical business, there is nothing more important than patient satisfaction. As an industry that already deals with distress and fatigue, providing accurate and timely information to patients results in directly improved customer service.

4) Claim Scrubbing

One of the most important stages to complete for proper claims reimbursement is claim scrubbing. It is an automated process to ensure claims meet reimbursement requirements from Medicare, Medicaid, or other private insurers. It checks for errors like incorrect coding or missing information which can delay payments or result in denials from payers. Now how is claim scrubbing an effective way to mitigate the risks of wrongful claims?

Claim scrubbing identifies discrepancies to make the necessary changes and adjustments before you send a reimbursement claim.

• It minimizes payment delays and increases your chances of receiving payment.
• Automated claim scrubbing checks claims against payer rules, reducing the time and effort required to review each claim. This reduces errors, denials, and underpayments due to incorrect coding.
• Automated claim scrubbing also makes it possible for your medical office to submit clean claims. This increases your office’s reimbursement rates and ensures claims are compliant with all applicable regulations.

5) Remittance & Filing Claims

Just as correct billing and claim scrubbing is an important part of the billing process, properly filling claims and processing remittances must be prioritized. Automation streamlines the remittance process by tracking payments received from payers without manual entry. You can track outstanding payments and payer follow-up. Moreover, with automated invoicing, you send electronic invoices while saving time on manual mailing or processing invoices. Here is how automated remittance and filing claims can improve reimbursement rates:

It reduces the wait time between your office receiving payment from a health plan and you’re processing it.

• As the system is designed to detect any errors, it increases payment accuracy and improves billing processes.
• When processing complicated claim payments, automated remittance will help you avoid mistakes in correctly assessing claims.
• For faster processing, Electronic Funds Transfer (EFT) transactions are delivered in file format CCD+, the recommended industry standard for EFT payments.
• It also helps you understand the Remittance Advice Reports (RAD) with information about Medicare claim payments.
• Streamline submitting 837 claim requests and 835 remittance files, which contain their explanation of benefits (EOB). This is a helpful tool for patients to understand exactly what they are charged for and how their visits translate into their billing.
• Automated remittance is a great tool for hospitals to recoup money quickly. With tedious processes streamlined for your benefit, you as an institution will improve your reimbursement rates.

Boost Your Recovery Efforts with Improved Reimbursement Rates for Medicare

With each automation tool integrated into your system, you are breathing new life into your workflow. These systems are designed to boost productivity yield better results and take the unnecessary load off the previous human labor that makes up the workforce.

You can increase your revenue recovery by automating your medical office’s billing system. Save time and avoid errors by reducing multiple data entries, automating easy payment tracking, and increasing payments on reimbursement claims from Medicare, Medicaid, or private insurers with scrubbing technology that identifies errors prior to submission. AI automates these processes for you, ultimately creating an efficient billing system!