Gynecology is a medical discipline that relies on difficult procedures and intricate billing guidelines. Small mistakes like incorrect demographic details or incorrect payer’s information can lead to delays of many days, weeks, or even months. Gynecologists receive claim delays on a regular basis, so their practices suffer the most from cash flow problems.
A professional medical billing company has trained staff, and they have the skills to tackle these rising issues. There are many strategies that may help OB/GYN billing services implement and get quick results. In this blog, we will discuss some of the best strategies that will help obstetrics and gynecology providers efficiently collect revenue. Let’s get down to it.
What Challenges OB/GYN Providers Face in their Daily Practice?
Obstetricians face numerous challenges at their clinics and in hospitals. This includes spending hours in birthing units or labor rooms and treating mothers and newborn children, etc. The problem arises when, after giving their best patient care, physicians don’t receive the payments for these appointments.
Secondly, the in-house billing team is already tasked with loads of work that creates hindrances to their performance. Thus, it leads to less productivity and unsatisfactory financial outcomes. Claim delays in submission and reimbursement add fuel to the fire for already-suffering practices such as small private clinics.
Therefore, a set of strategies can be selected for adequate implementation throughout a provider’s revenue cycle management. In the next section, we will be discussing a master plan for tackling common and complex issues. Solving them will enable OB/GYN practitioners to get the maximum return on services rendered to patients.
Top Strategies For Enhancing Revenue Cycle Management of OB/GYN Claims
There are various types of strategies that enable medical practitioners to increase their revenue. It depends on the nature of the complexities presented to each specialty and what problems they are facing on a regular basis. Our medical billing team has highlighted some of the common mistakes in gynecology billing claims and how to rectify them appropriately. Let’s go through them one by one for deeper understanding:
1. Identify Leaking Revenue
The first strategy for increasing revenue is to discover areas of revenue leakage. It is a well-established fact that gynecological practices are overburdened and overcrowded. Accurately identifying weak performance areas is cumbersome for a gynecologist’s billing team.
On the other hand, this step enables medical billers to evaluate where they can help your practice improve. A thorough investigation can be initiated to determine whether unsatisfied patients are the main reason for less revenue or not. For instance, if new patients are not adding up and chronic ones are leaving for new physicians, it will definitely result in the leakage of valuable revenue.
Secondly, this leakage can be due to incorrect codes, collectively known as entity code rejections, etc. Errors in billing and coding of the insurance claim can cause big financial implications and damage earnings chances. Therefore, finding revenue leakages and applying appropriate solutions may serve in the best interest for the long term.
2. Timely Submission of Patient Claims
The second strategy that makes a big difference in obstetrics and gynecology revenue cycle management is the prompt submission of patient claims. If billers send claims after the mutually agreed time and date, then it results in denials or rejections. Thus, no matter how much time a gynecologist has spent on a patient, they will not be paid.
Typically, in the gynecology department, administrative staff is constantly under immense pressure. The overburdened in-house billers are in the habit of submitting all claims at the end of the day or sometimes after many days. Usually these claims miss some critical details and procedures that are overlooked, thus the claim contains only half details.
Likewise, late claim submissions are in violation of adequate quality checks and a mutually agreed-upon time. Hence, reimbursement claims become susceptible to the payer’s rejection.
On the other hand, when a claim is adequately checked and submitted before or on time, it has an acceptance rate of over 90%. Therefore, punctuality is the key to making a difference in earning from patient claims.
3. Quick Solution for Claim Denials and Rejections
The third strategy revolves around providing a quick solution to insurance claims, either rejected or denied. An efficient team can anticipate such occurrences and has a dedicated team of billers who, once these claims are received, work on them thoroughly.
Secondly, providing training to the coding and billing teams on the appropriate handling of claim denials and rejections is very important. Basic and advanced training can mitigate the shortcomings of administrative personnel. Training can address many issues and lack capabilities that a provider’s team is unaware of. Thus, any designated time and day can be selected, and the process can be started.
In the presence of a dedicated and trained team, prompt solutions can be applied quickly and solid results extracted easily. Furthermore, the financial implications of delayed claim reimbursement can be avoided accordingly.
4. Automate Obstetrics and Gynecology Billing
The fourth step that may help in the long-term enhancement of revenue cycle management is automation. Technical advancements have played a significant role in minimizing financial losses. Trusted and easy-to-use software can be vital in streamlining coding and billing processes.
Automation helps in achieving transparency and dependency on tried-and-tested solutions. For this purpose, appropriate training on using and understanding its features can be communicated. Billing software helps gynecology providers avoid the clerical mistakes that are common in manual billing input.
Additionally, these softwares are best at detecting anomalies such as discrepancies between the provider’s NPI and billing plan, etc. Hence, many errors in patient claims can be avoided rather easily.
5. Outsource OB/GYN Coding and Billing Company
The last and most important part of strategy is outsourcing your billing and coding departments to a capable and reputed company. Administrative oversight is a given when the staff is overburdened; it’s only human. But the process can be optimized and made better with the help of hired patient billing companies.
Similarly, hiring a patient billing team allows providers to close the door to typical mistakes that cost them valuable revenue. On the other hand, outsourcing also helps in avoiding training costs associated with the job.
Since a medical billing company provides an already trained and certified team that excels at doing their job, There’s no need to train their staff, so a lot of money can be saved for such expenses. Trained and skilled billers are a guarantee against unwanted bad debts and loss of revenue by costly denial of services. Delegating the responsibility of making patient claims and submitting them on time rests better in the hands of a professional team.
Conclusion
It is well understood that OB/GYN billing is plagued with administrative mistakes and unskilled in-house teams. Providers get to bear the negative consequences like claim denials, rejections, bad debts, and loss of revenue. However, hiring a reputable team allows for minimizing these costly and typical mistakes. Additionally, these companies offer services that are two to three times less expensive than maintaining an in-house team.
Medheave offers medical billing and coding services for obstetrics and gynecology practices throughout the USA. We provide quality-centric patient claim submissions that are mistake-proof and help healthcare facilities earn more revenue and have high patient satisfaction levels.
Lastly, our medical billing services result in a two-fold increase in claim reimbursements and a massive 50% decrease in denials. Hiring our billers provides greater transparency, efficiency, and revenue collection that’s not achievable by in-house teams.
