Why your cash flow is decreasing?

Today’s increased federal scrutiny of billing practices has made providers revenue decrease. Increased insurance carriers and federal regulatory demands and scrutiny mean it’s more important than ever to have accurate coding, billing and documentation.

With the complexity in the billing process, even a small number of billing errors can result in significant losses. Your practice may face fraud and abuse issues if billing personnel do not understand insurance complexities and their impact on the process.

Inexperienced or improperly trained billing personnel can unwittingly create cash-flow difficulties for your practice through inappropriate claim filing. The lack of proper training and failure of the office personnel to follow up on unpaid claims can quickly result in a backlog of outstanding claims. Too often, billing personnel do not have the time or the expertise to research and resolve claim problems, as it is the complicated tasks of reviewing claims for accuracy and compliance with payer rules, following up on denials and researching claims with payment variances (ex. write-off). Write off can drain your finances.

Most of the medical practices have the wrong perspective when it comes to clinical and billing departments it is there where all go wrong. The communication between the clinical personnel and the coders is essential to maintain a successful practice. Example, the record has an injection procedure but for some reason the information is incomplete, if the coder notice the error it can be corrected right away. But this information is mostly clinical and if there is no communication between the departments it will go unnoticed and when the insurance request the record it will be deny for lack of information.

It’s also important that every provider office have regular coding, billing and documentation audits to identify risk areas and minimize the revenue loss. In offices without compliance managers make sure the billers and coders have knowledge on clinical documentation compliance for a successful financial and professional practice.

Have in mind that every year, state and federal regulations changes along with coding and documentation standards.