How To Reduce The Friction Inherent To Medical Billing

by  Find-A-Code™
Aug 4th, 2022

There is a certain amount of friction inherent to the medical billing process. Between hundreds of thousands of codes, different billing platforms, and a system that seems to be continually in flux, getting through the day without friction is nearly impossible. But that doesn't mean medical billing and coding specialists need to accept an excess of amount of friction. There are ways to reduce it.

The three keys to reducing friction are accuracy, efficiency, and timeliness. Focus on these three things and medical billing is not nearly as hard as it otherwise could be. Below are some helpful tips for doing just that. In the meantime, we invite you to take a look around our site. We have built a comprehensive online database that makes finding even the most arcane diagnostic codes as easy as possible.

1. Emphasize Clean Claims

One of the primary sources of medical billing friction are incomplete claims. Payers have no trouble sending claims back because they are lacking critical information. What is the solution to this particular problem? Emphasizing clean claims. If you work alone, clean claims are your sole responsibility. If you are part of a team, every team member has a responsibility to produce clean claims.

As you know, a clean claim includes all the required information – no exceptions. In addition, all the submitted information needs to be accurate. Yes, it takes time to go back and double-check a claim prior to submission. But it takes less time than having to go back and revisit a claim rejected by the payer.

2. Submit Claims Daily

In addition to emphasizing clean claims, you will probably find it helpful to submit claims on a daily basis. Even if your office only has a few claims at the end of a given day, submit them. Letting them stack up until the end of the week only creates more work that could lead to staff rushing through their work.

An added benefit of daily submissions is the ability to keep track of rejections more easily. Just like you are not dealing with a whole stack of claims at one time with daily billing, you are also not facing a ton of rejections that all come in at once. Simply put, daily billing tends to be more efficient.

3. Standardize Your Codes

Billers that utilize multiple coders often create friction for themselves by not insisting that all the coders use the same ones. The easy solution to this is standardization. If management prefers ICD-10 over ICD-11 for example, make sure everyone on the team is using the former. Not only does this make it easier to decipher the codes, but it also makes finding errors easier.

You may run into a situation where a particular payer mandates the codes your facility uses. If they are the only payer with such mandates, you could standardize all your codes to that payer's needs. Otherwise, you may have to maintain separate code standards for a small number of your payers.

4. Review and Modify Procedures

Last but not least, your organization undoubtedly has billing procedures in place. How long have those procedures been utilized? It is a good idea to review them, at least annually, and make any modifications needed to increase accuracy and efficiency. If you haven't reviewed your procedures lately, doing so is the first step in reducing friction.

Not all the friction inherent to medical billing can be eliminated. But to the extent that it can be reduced, medical billing becomes easier. Reducing friction is a worthwhile goal that every medical billing department should shoot for.