Proactive Billing: Healthcare

Medical Billing - Complete Controller

Following a myriad of financial issues and compliance risks, adopting a proactive approach to billing procedures in a medical office and the healthcare industry, in general, has become necessary. In an attempt to revamp healthcare industry revenues and reduce patients’ costs, effective billing procedures may be introduced, which will be discussed in the following paragraphs.

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

Moreover, collect all relevant information from the patient, such as an address, contact number, email, work location/name of the company, and a photo ID. Verify the addresses provided by the patient and verify 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.

Before taking them on board, any payment plans must also be introduced to each one. Make it a habit to email patients a few days before their payment is due and on the payment date. Multiple emails may be sent as reminders once the due date has passed.

Claims Management

Another effective billing procedure to incorporate is submitting accurate and complete claims. This accuracy may be ensured using a detailed review of entered data points. Possible errors comprise incorrect patient data, insurance information, duplicate billing, missing denial codes, incomplete documentation, and inaccurate provider information.Complete Controller. America’s Bookkeeping Experts

To effectively reduce these errors, double-check all information to minimize the risk of error. In addition to this, effective billing requires the 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 many tasks. These tasks span from staying updated with the current trends in medicine, coding standards, insurance policies, and billing regulations to processing denials, rejections, and re-submission of claims.

These tasks and procedures can be outsourced to reboot the energy and save time and effort. Such outsourcing will allow for greater focus on patients, agile submission of claims, and specialized billing experts to process billing-related matters efficiently.

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Another effective billing procedure is to spot errors and try to minimize them. This minimization must be a consistent process in a medical office 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 inaccurate modifiers.

The less frequently occurring errors comprise upcoding and under-coding in the medical language. These errors may be avoided by double-checking the claims before submission. In addition, 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 any pending receivables (similar to receivables in bookkeeping), staying up to date with the dynamic healthcare procedures and policies related to billing, and submitting claims.

As a result of these improvements, billing is made more effective, but efficiency is one benefit, and revenue maximization for the healthcare industry is yet another.

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