Calculator and stethoscope on financial statement concept for finance health check or cost of healthcare
Following a myriad of financial issues and compliance risks, it has become a necessity to adopt a proactive approach to billing procedures in a medical office and healthcare industry, in general. In an attempt to revamp healthcare industry revenues and reduce patients’ costs, effective billing procedures may be introduced and these will be discussed in the paragraphs that follow.

Collection Process

The initial step towards establishing effective billing procedures in a medical office is to have a collection process. The collection process should start off with the setting of terms and mutual agreements to these. Make sure that the patient is aware of their obligations and debts and keep a reminder for each patient to settle pending obligations. These terms must be agreed upon as part of the initial paperwork.

Moreover, be sure to collect all relevant information from the patient such as address, contact number, email, work location/name of the company and a photo-id. Verify the addresses provided by the patient and make a habit of verifying patient eligibility on each visit to the medical office. An effective billing procedure communicates the various payment options available to all patients, preferably on their initial visit to the medical office. Any and all payment plans must also be introduced to each one prior to taking them on board. Make it a habit to send emails to patients a few days before their payment is due and on the date of payment. Multiple emails may be sent as reminders once the due date has surpassed.

Claims Management

Another effective billing procedure to incorporate is the need to submit accurate and complete claims.  This may be ensured using a detailed review of the data points entered. Possible errors comprise of incorrect patient data, insurance information, duplicate billing, missing denial codes, incomplete documentation, and incorrect provider information. In order to effectively reduce these errors, double check all information to minimize the risk of error.

In addition to this, effective billing requires proper handling of rejected and denied claims. Once all errors have been fixed, the rejected claim may be resubmitted. In case of a denied claim, re-submission is preceded by an appeal. Be sure to have these pointers in mind before processing claims.


Effective billing procedures can be costly and despite having proactive procedures, medical office staff may feel overwhelmed by keeping up with a plethora of tasks. These tasks span from staying updated with the current trends in medicine, coding standards, insurance policies, billing regulations all the way to processing denials, rejections, and re-submission of claims. In an attempt to reboot energy and save time and effort, these tasks and procedures can be outsourced. Such outsourcing will allow for greater focus on patients, agile submission of claims and specialized billing experts to process billing related matters in an efficient manner.

Minimize Errors and Improve

Another effective billing procedure is to spot errors and try to minimize these. This must be a consistent process in a medical office in order to ensure revenue maximization and lower costs. Claims include medical codes that may either be incorrect or missing from the claim. A few examples of these errors are non-specific diagnosis codes and incorrect modifiers. The less frequently occurring errors comprise of up-coding and under-coding in the medical language. These errors may be avoided by double checking the claims prior to submission.

In addition to this, another effective billing procedure is called improving and, mind you, this is not a medical term! By improvement, it means new methods should be adopted to ensure constant improvement in billing procedures. These improvement steps include tracking of any and all pending receivables (similar to receivables in bookkeeping), staying up-to-date with the dynamic healthcare procedures and policies related to billing and submission of claims. As a result of these improvements, not only can billing be made more effective, but efficiency is one benefit and revenue maximization for the healthcare industry is yet another.

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