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The Importance of Streamlining your Claim Management Process

by | July 17, 2020 | 8:57 am
Category : Claims Denial Management
The Importance of Streamlining your Claim Management Process

For a DME/HME, patient concerns often come bundled with the added element of required urgency. 

Based on a report by the Centers for Medicare and Medicaid Services (CMS), the need to rapidly reach medical care has led to video consultations, rather than in-person consultations, in times of emergencies. This innovation has helped countless people receive medical care during the time of the COVID-19 pandemic. The report also highlights a surge in telemedicine service beneficiaries during the pandemic. While only 13,000 beneficiaries of fee-for-service Medicare received telehealth services weekly in the pre COVID-19 times, the number exhibited a steep rise to nearly 1.7 million beneficiaries in the last week of April 2020. In all, more than 9 million beneficiaries have received telehealth services during the period of the health emergency from mid-March through mid-June. Here, telemedicine services include those services that are on the Medicare telehealth list, including audio-only visits, virtual check-ins, and e-visits. 

The outlook for health care businesses

The note of urgency can translate into missing documents and incomplete records at the time of registration. For the purpose of medical billing, this can negatively impact payments, lead to delays in getting paid or worse, complete loss of payment. In these times of COVID-19, a business may shut down completely if not paid. Healthcare businesses need to focus on sustaining the business and eventually developing capabilities to thrive during a crisis.

The Importance of Streamlining your Claim Management Process Infographic

Claim management in medical billing

  • Effective claim process management needs to be seen as an essential element of medical billing rather than an optional feature.
  • Claim management can prove to be complicated: once filed, claims must be followed. For business owners, apart from making demands on their time and attention, poor claim management can also result in denials.

Streamlining claim management helps in multiple ways:

  • Streamlining the claim management is an effective way of closing payments and reducing overall turnaround time.
  • Identifying challenges in the billing system and resolving them contributes positively to overall cash flow management.
  • Ensuring compliance with HIPAA rules also contributes positively to Revenue Cycle Management.
  • Tracking outstanding receivables or accounts receivables helps collection by providing accurate information to prevent delays in payment or an increase in bad debt.

Changing slowly, one record at a time

A successful, proven process begins one step at a time. As businesses emerge from COVID-19, they face the prospect of reduction in staff, low morale, and decreased paying power across all sections of society, and a ravaged economy. A little planning and some judicious use of technology can help your business find a foothold and become sustainable. Beginning with reliable record-keeping, slowly moving to creating process efficiencies with essential tasks like efficient accounts receivable, a streamlined operational process can help your DMEs/HMEs gain momentum. When augmented with the right technology and cost-effective solutions, such as partnering and outsourcing, your healthcare business can position itself for sustainability and growth.

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