Every year, medical providers and systems spend $360 billion on administrative expenses, including keeping data private and secure (HIPAA-compliant), communicating with patients, receiving third-party lab results, and of course, insurance billing.

As any healthcare practitioner knows, insurance billing is a somewhat complex process that involves efficient communication between several parties, including the provider, patient, and the insurer.

The admin staff responsible for insurance billing typically oversees the following:

  • Understanding the patient’s individual responsibility for payment.
  • Evaluation and analysis of insurance coverage.
  • Preparation of accurate billing forms.
  • Collection of accurate payment from both the insurance plan and the individual patient.

It may seem fairly simple. But in this process, there’s much room for error, delays, and complications. How does this affect the practitioner? Wasted time on administrative back-and-forth. Wasted money on paying administrative staff for hours of extra work. And wasted resources and effort on dealing with insurance, instead of focusing on delivering quality healthcare.

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Primary Problems with Insurance Billing

Medical care providers spend $282 billion alone on insurance and medical billing costs…and many of those costs have been deemed “excessive,” according to a brief published by the Center for American Progress.

Here are just a few of the primary problems with insurance billing:

Failure to Record Patient Information Correctly

When patient information – such as name, address, social security number, or other vital information – is recorded incorrectly, claims can’t be billed and collected accurately.

Unfortunately, administrative errors like this happen all too often. The result? Your staff must contact the patient and the insurer, and take the time to resolve the error. Not only that, but you as the provider, don’t get paid on time – and miss out on timely revenue.

Eligibility Issues Resulting in Claims Rejections

When the eligibility of a patient to be provided certain kinds of medical care is in question, claims can be rejected. Part of the problem is an overall lack of standardization in the health insurance industry: How insurers interpret claims, and the reasons they give for denial vary.

Rejected claims only produce more administrative burden, by bringing all involved parties into a back-and-forth to try and resolve the situation and correct any errors involving eligibility. If the provider originally claimed that the service would be covered – and it’s not – the patient isn’t going to be happy.

Claims Denials

While claims that are rejected can usually be resolved by addressing and fixing an error, healthcare claims that are denied need to be appealed to be overturned. In other words, the patient needs to prove why a specific service should be covered.

If your patients received care from your practice that results in a denied claim, you may need to work with the patients in order to resolve the problem, causing further administrative burden. 90% of all claims denials are actually preventable, but nearly one-third of healthcare providers still use a manual claims denial system, unnecessarily complicating the system.

Errors in Coding Claims

When the eligibility of a patient to be provided certain kinds of medical care is in question, claims can be rejected. Part of the problem is an overall lack of standardization in the health insurance industry: How insurers interpret claims, and the reasons they give for denial vary.

Time-Consuming Processes

Finally, insurance billing can be an extremely time-consuming process. Even if insurance billing goes smoothly, it can still be a complex, somewhat time-consuming task. Add administrative errors and you have additional hours of labor (and paid wages).

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Solutions for Healthcare Practitioners

With so many mistakes to be made and so much money and time to be wasted, how can you avoid paying excess costs for insurance administration?

And more efficient administration begins and ends with using a streamlined electronic system for paperwork, patient communication, scheduling, and of course, insurance billing.

Errors, delays, and needless hours of labor involving insurance and other administrative communication can be mitigated by the usage of electronic medical records (EMR) over paper documentation, and a single, streamlined platform for patient- practitioner communication. Healthcare providers can also see significant progress by training their staff to code correctly.

Electronic Medical Records (EMR)

One of the most significant problems facing healthcare administration is the likelihood of errors, including patient misinformation.

Electronic Medical Records (EMR) can mitigate the likelihood of making an error with a patient’s name, contact information, personal health information, or social security number by streamlining the paperwork process.

EMR allows patients to fill out their forms before an appointment, send the form directly to their provider, and create a safe, secure record that doesn’t require recopying, scanning, or uploading. The result is a more time-effective process that helps ensure patient information is communicated accurately upfront, and reduces the possibility of error.

Electronic paperwork can also offer practitioners additional benefits. EMR makes many processes mobile-friendly for both patient and provider, and provides the freedom and flexibility to create branded, integrated forms.

An Electronic Platform

A single, streamlined electronic platform can help healthcare providers streamline all administrative processes – including patient communication, scheduling, appointment confirmations, patient profiling, patient surveys, and more.

Using the same platform for insurance billing, electronic paperwork, and all other admin tasks can significantly simplify work for front-of-office staff. In fact, using such a platform may even eliminate the need to hire additional employees. Nourish Family Nutrition is a healthcare practice that found it was possible to use just one admin to perform tasks – including insurance billing and coding – by adopting an electronic platform.

Staff Training

Coding errors can be prevented by providing proper training to the responsible staff.

billing insurance

Administrative staff can participate in courses that teach them to properly code for various medical procedures and diagnoses. Of course, the more complex the care, the more complex the coding.

Grab “7 Steps to Faster, Easier Administration” while you still can!

IntakeQ: An Electronic Platform to Help You Simplify Insurance Billing

IntakeQ is a software platform that can help healthcare providers save time and money on the process of insurance billing by:

  • Making patient-provider communication more efficient and streamlined
  • Reducing the possibility of paperwork-induced error with electronic medical records
  • Lifting administrative burden from staff
  • Uniting insurance billing with additional processes, creating a single system for increased accuracy and ease of use

A practitioner’s attention and funding should not be absorbed by administrative tasks involving insurance, correcting errors, and communicating needlessly with third parties. By cutting down on errors and time, practitioners not only save on paying for staff (and receiving delayed payment from insurance companies), they also potentially free up time and resources to focus on providing better care. By using IntakeQ, private care practitioners create more space to concentrate on what they love to do the most: Helping their patients to heal.