Family medicine practices are one stop where all patients get their medical checkups. From neonates to older patients suffering from chronic illnesses like diabetes, hypertension, etc., all are catered to in this domain. Family medicine practitioners are generally overwhelmed with a long list of appointments; thus, their practice requires professional help.
On the other hand, if a primary care physician has untrained and uncertified billing staff, this becomes a dilemma. A single mistake can result in a loss of revenue or claim rejection. These reimbursement delays may cost them valuable income.
Therefore, today we will look at some of the important features that will help providers sort through these issues. We will also present solutions such as outsourcing the patient billing department for the best overall financial results. So, let’s delve into this topic for a better understanding of and optimization of revenue cycle management.
What is a Family Medicine Practice?
A family medicine professional is a primary care physician. They treat patients as old as one year to a hundred or more. They are trained to provide healthcare to patients suffering from common colds, fevers, infections, and chronic illnesses. Lifelong diseases such as diabetes, hypertension, chronic kidney disease, and asthma are all treated by them.
These physicians have patients who have been with them for many years or decades. Thus, they are experts who care for sufferers and alleviate them accordingly. Being a primary care physician allows them to build a huge pool of patients they treat each day.
On the flip side, if a family doctor’s claim department is unable to bill patients, their practice suffers from huge financial losses. Claim rejections are a common part of their practice. But denials put them at losses that are just bad debt, and they have no other choice but to treat them as write-offs. Stable and skilled family practice billing services are imperative to the financial sustainability of such practices.
Custom Made Medical Billing Solutions For Challenges of Family Practices
Family medicine practices play an important role in improving quality of life. This significance propagates the need for a billing company that specializes in this discipline. Here are the detailed challenges family healthcare providers face on a daily basis. Also mentioned are the benefits of outsourcing billing and coding that will help in coping with these challenges.
Accurace Coding
Medical coding is assigning correct codes to procedures such as surgery, diagnostic scans, etc. Professional coders are trained to understand a physician’s remarks and diagnosis while turning them into specific codes.
On the contrary, having untrained staff with no familiarity with medical jargon can make it harder for billers to accurately charge patients for their insurance plans. Outsourcing coding services to a professional billing organization provides these important practices with long-term financial stability. Providers can earn a good chunk of revenue with accurate coding from an AAPC (American Academy of Professional Coders)-certified team.
Timely Submission of Claims
A golden rule of thumb is to create insurance claims after a doctor has provided all the services to patients. A slow or unskilled in-house team mostly overlooks the importance of timely claim submissions. Due to this, many details are left out of the superbill pertaining to less reimbursement revenue in comparison with the services provided.
So, this imbalance between rendered services and charges on insurance plans results in mounting bad debt. Even after adding new details, it’s less likely that insurance companies will pay the full amount after compensating for the first claim.
Likewise, small private family practice providers can suffer big losses. Whereas, such negligence can be avoided easily by hiring skilled medical billers. Billing services from a prominent organization help practitioners make timely submissions and reimbursements appropriately.
End-to-End Revenue Cycle Management Services
Family physicians also face challenges, such as finding a complete solution to their practice’s problems. A versatile medical billing company vetted by various prominent healthcare facilities can help achieve those goals.
Now, physicians can get custom-made billing solutions for optimizing their revenue cycle management. An organization that offers end-to-end CRM services helps in many aspects, such as:
- Denial management
- Payment posting
- Healthcare data analytics
- Availability in all 50 states
- Prior authorization services
- A/R recovery services
- Insurance eligibility verification services, etc.
Having a group of experts that can do all these tasks related to patient billing provides peace of mind to providers. Additionally, the revenue stream remains undisturbed when choosing such solutions.
Perfection in Patient Billings
Patient billing is by far the most daunting challenge that exerts pressure on in-house billing staff. Since family medicine physicians are constantly busy, they are more likely to take this hit.
Additionally, already overburdened staff play their part in this, which results in big discrepancies in financial audits. Daily overlooks cause massive disruptions in cash flow that leave healthcare facilities vulnerable to bankruptcy.
Hiring billing experts not only helps in avoiding such heavy losses but also negates the inefficiencies of the in-house team. These personnel help with claim scrubbing as well, leaving your claims over 99% in perfect condition. After filing these insurance claims, reimbursements are guaranteed to be accepted by payers.
Reduction of Administrative Cost
Financial challenges entailing family clinical practices are immense. These include administrative costs pertaining to hiring staff and additional personnel for night shifts,etc.
Similarly, providers pay a significant amount of money for all of these costs and associated ones as well. Practices that have to spend half or more on these incurring costs suffer terribly from an imbalance of payments. This results in bankruptcy and even the permanent closure of patient care services.
It has been observed that outsourcing allows greater versatility in financial operability for healthcare facilities. Family medicine providers can take help from patient billing companies and shed financial burden. This step provides financial independence. It also helps in generating more revenue while spending a fraction of the amount on outsourcing.
End to Training and Skill Enhancement Expenses
Maintaining a good staff is effective when training and skill enhancement training are provided at regular intervals. Arranging these programs comes with a big financial toll and affects small practitioners as well as larger ones. Meeting these training goals is not easy; thus, appropriate planning is required to keep up with good standards.
But, when it comes to hiring third-party patient billers, they have been trained before joining a clinical practice. Hence, physicians can rely on them right from the first day. This not only helps healthcare facilities with top-notch skills in patient billing but also in submitting claims in a timely manner.
The Bottom Line
Family medicine is an important part of medical science and will continue to play a role in alleviating patients’ suffering. The use of family practice medical billing services ensures practitioners get paid quickly for the hard work they put into patient care. This way, many shortcomings, such as denials, claim rejections, and delays, can be rectified appropriately.
Additionally, it is in the provider’s best interest to outsource skilled billers so their rendered services are reimbursed. Hiring allows greater flexibility in the operations of a healthcare facility.
Secondly, private and large-scale practices can save a lot of revenue by using such companies. It all adds up to the overall optimization of revenue cycle management in clinics and hospitals.
