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How to Optimize Medical Billing and Collection?

Nov 19

Efficient medical billing and collection processes make a medical practice successful and profitable. However, collecting payments from patients as well as insurers has become more complex. The main reason behind this complexity is the rise in required documentation and the number of patients responsible for their medical bills. 

In this article, we have compiled a list of some medical billing tips that will optimize your medical billing and collection. While some of these tips are easy to implement, you may go for outsourcing medical billing for others. 

Tips To Optimize Medical Billing and Collection

Correct coding!

In order to optimize your medical billing, the first step is accurate medical coding. Getting coding right helps to optimize the revenue cycle management healthcare. In addition, proper medical coding helps in reducing claim denials and increasing reimbursement.  It is reported that the average cost to resubmit denials is between $8-10. Therefore, in order to improve collections, accurate coding is a must.

Collect from the patient at the time of service

Another way to optimize medical billing and collection is by collecting as much as one can from the patient when the service is provided to them. Most patients know that they will have to pay some amount out-of-pocket, and as a medical practice, it is your duty to keep them informed. Patients can be kept informed by 

  • Checking eligibility of patient before the appointment
  • Handling the requirement of pre-authorization in advance
  • Notifying patients of the co-pays that must be paid at the time of service
  • Posting signs throughout the office to let patients know 

Use practice management software 

You can also optimize revenue by decreasing the sum that is spent. Upon filing a paper claim, someone needs to fill out the form, check for mistakes, and then send it to the insurer or whoever the payer is. You can’t ask a care provider for that as they already are doing so much. This implies that you will have to hire someone to do the tasks as mentioned earlier, which means that the overhead costs will rise. In addition, the claims often get denied, and thereby the submission process has to start from the beginning. 

A Practice management software or outsourcing medical billing services can make all of this faster and easier. Medical billing service providers or the software automatically check for coding errors and permit filing and capping the claim’s status automatically. 

Outsourcing medical billing or buying the Practice management software can decrease waste, minimize the wait, and reduce delivery costs. In addition, this software also interfaces with your accounting software, keeps track of your revenue growth, and helps you analyze your ROI.

Manage claim denials 

In order to keep a healthy cash flow, the forever evolving healthcare industry needs a practical denial management system. Most practices try to keep their clean claim ratio high, but unfortunately, claim denials always occur. These claim denials disturb cash flow by adding extra costs to the collection drive. Therefore a practice should always use correct coding and submit clean claims in order to decrease the denial rate.

Having the right strategy to handle claim denials is very important because these denied claims can keep you away from your well-deserved payments. Try to prevent denials from happening in the first place in order to have an efficient practice. You can always opt for medical billing services. When you outsource medical billing, then it is their headache to take care of the denied claims.  

Allow easy ways to pay the remaining balance.

It should be noted that the money that is not collected at the time when the service is provided is hard to get. Therefore, it is very important to ensure that the statement that the patients will get in the mail is simple and easily understandable. The practice should send the statement as early as possible so that the patient remembers the service and pays too. In addition, there should be multiple paying options apart from the traditional paying methods. You can open up the option of online billing as it is easy for the patient to view their bill and pay online. 

Make sure that you are documenting all charges.

Medical practice should always document all the charges in order to ensure that your practice does not get overpaid or underpaid. If your practices go for in-house billing, then make sure that experts review the coding done by your staff in your office or by the experts of the outsourcing medical billing company. All procedures and patient data should be captured effectively. An EHR system is a very good tool in order to document all the charges.

Outsource medical billing services for your practice

In-house medical billing is often frustrating, as it consumes a lot of time as well as money. The money and time wasted there can be used to grow your practice and cater to more patients. This is the reason that many healthcare practices go for outsourcing medical billing services.


Outsourcing medical billing services help you to save time and costs. A good medical billing company assigns most claims and their collections tasks to their expert medical billers and coders. If you want to outsource medical billing services, ensure that you opt for a third party who has a lot of experience with medical billing, coding, and claim collections. If you are looking forward to it, it is recommended you check out UControl Billing. 

UControl Billing is one of the top medical billing companies in the USA. They have a team of expert medical billers and coders, and they also provide the most affordable medical billing services all over the USA. For further information regarding their service, visit their website now!