In the busy billing office of any physical therapy practice, mistakes are bound to happen. With so many details to manage, it’s nearly impossible to stay completely error-free.
Even though the importance of medical billing and coding is frequently viewed as back-office duties that can wait, they ultimately determine the financial stability of a healthcare practice. When your billing functions properly, cash flow remains consistent and predictable. But when billing systems fail, payments are delayed and denials increase.
A major antitrust lawsuit involving MultiPlan (now Claritev) and several top insurers is making waves in the healthcare industry. The MultiPlan lawsuit challenges how out-of-network (OON) reimbursement rates are set, and the outcome could significantly affect how providers are paid. At Park Medical Billing, we stay ahead of these developments
Creating a system to maximize efficiency in handling denied claims is a must especially when we deal with active healthcare claims processing. A structured medical claim management approach helps practices reduce revenue loss and improve overall reimbursement performance.
Effective Revenue Cycle Management contributes to the success of any medical practice — and that’s a fact. The following are few of the practices to optimize your medical billing and improve your revenue cycle.
Negotiation. It’s tough to do successfully, especially when it’s not something you were trained for.
As a physical therapist you’re trained to treat people and help them live better and healthier lives, not make financial negotiations. But the fact is you can’t continue to do what you’re trained to do without having to negotiate terms of payment first. This negotiation doesn’t mean simply agreeing to whatever the payer says– it’s making sure you get what your time, service and skills are truly worth– and that’s the hard part right there.
Fortunately there are ways to negotiate terms to your benefit. Following these tips and armed with the right facts and figures, successful negotiation can be achieved.
The first thing you need to do in order to negotiate successfully is to analyze your current payers’ performance and fee schedules. Identify the payers with whom you do the most business along with the most common CPT codes you use. Get the number of times you bill each code with each payer, and multiply each number by the proposed payment amounts. Then add up all the totals per payer and divide by the total number of codes billed. This should give you the weighted average for each payer, and a good indication of which contracts are most valuable to you.
Apart from this you could also compare the rates of individual CPT codes and approach payers who pay the least amount about increasing to at least reach the average reimbursement rate for these codes.
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