The challenges of billing for multi-doctor practices can be compounded by the increased risk of coding errors, claim rejections, and compliance problems from multiple providers with different styles of documentation, shared services, and disparate arrangements with payers. This is the place where the power of automation within medical billing services is going to be transformative.
Increased automation, through new medical billing services software, has allowed practices to be able to streamline workflows, reduce the impact of human errors, and speed up the collection of reimbursements. The billing mistakes that are prevalent in multi-physician practices are almost always able to be covered with automation.
Primary Causes of Billing Errors
In multi-doctor practices the primary causes of billing errors are:
- Inconsistency in documentation between providers
- Charge entry errors in medical billing services
- Inconsistency in coding
- Missed modifiers
- Failure to verify eligibility in a timely manner
- Lack of follow up on denial
The issues are compounded by a lack of automation in the process. When staff are called to do repetitive data entry tasks, the occurrence of errors is virtually a given. The impact of errors, no matter how small, can result in a denial of a claim, a delay in payment and an increase in the cost of the medical billing services.
How Automation Reduces Billing Errors
Enhanced automation tools in today’s medical billing services software solutions capture and address challenges at various levels:
1. Smart Charge Capture
Automated systems capture charge entries accurately by pulling from EHRs. This reduces duplication and transcription errors, and ensures that every billable service is captured correctly.
2. Coding Check
Before claims are submitted, automation platforms with a rule-based engine and AI identify mistakes in combination edits for CPT, ICD-10, and modifiers. This validation reduces rejection rates.
3. Proactive Verification of Eligibility
Automated systems check eligibility coverage gaps in claims denial. These systems reduce errors at the front desk of multi-provider clinics and increase the rate of first-pass claim acceptance.
4. Automated Denial Management
Most services use analytics that categorize denial trends and automatically create correction workflows. Rather than waiting and doing follow-up steps, practices are able to take preventative steps.
5. Consistent Automated Billing Workflows
Automation ensures that consistent billing workflows are used by all providers. This is especially important for larger practices and medical billing services for hospitals.
The Role of Outsourcing with Automation
Some practices opt to outsource their medical billing to specialized medical billing companies that use automation. The billing companies use a combination of trained billing staff and computer software to automate billing and increase accuracy.
The advantages of outsourcing medical billing services include:
- Access to state-of-the-art automation services
- Less administrative work
- Reduced costs for hiring and training
- Easier monitoring of compliance
- Revenue cycles are quicker
- Multi-doctor practices are able to outsource billing and keep billing accurate, even as the number of patients increases.
Cost vs. Value of Automation
A challenge for some administrators is the cost of medical billing services and the value lost with automation. However, the cost of automations initial investment is outweighed by a reduction in denied claims, an increase in collections, and fewer days of accounts receivable.
Automated medical billing services for provider groups typically result in:
- Claim rates that are first-pass and higher
- Reimbursement that is quicker
- A lower risk of being out of compliance
- Less administrative work
In hospital medical billing services and other high-volume situations, automation is also no longer optional; it is necessary for financial sustainability.
Final Thoughts
In a multi-doctor practice, billing professionals are able to be more accurate, consistent, and efficient, and billing professionals are able to do their work more easily with the use of automation. Automated systems and billing companies are able to cut the number of billing mistakes and increase revenue.
As the healthcare industry continues to change, the practice of using automated medical billing services will be beneficial to healthcare providers for reducing risks, controlling costs, and achieving continuous profitability.
