Providers, practice administrators, and office staff members should be well versed in the basic components of the revenue stream to maximize revenue while staying within compliance guidelines.
To keep a close watch on revenue, practices must take the following steps:
Review unbilled charges daily. Failure to send claims out on time may result in lost revenue and a sluggish cash flow. However, it's not uncommon for a billing department or service to delay billing while awaiting completion of the following:
Capture all services rendered. Encounter forms, paper and EMR-based, should be updated at least annually. The most efficient way to accomplish this task is for billing personnel to meet with providers and take these steps to verify that all services rendered are captured through appropriate codes:
Revise fee schedule annually. Most third-party payers issue a new fee schedule annually. Therefore, practices should check their fee schedules to make sure they bill above the allowed amount of the highest third-party payer billed. Staff members must also ensure that charges are paid correctly according to the fee schedule.
Keep your eye on the denials. One of the best ways to maximize revenue is to have claims paid the first time they are submitted. Once a claim is denied and has to be corrected and rebilled, the practice is not only paying office staff for this extra work, but the cash flow is slowed down.