Simplify Claim Processing: Outsourcing Medical Billing Processes

by | January 13, 2021 | 12:12 pm
Simplify claim processing

Medical billing can be complex and challenging, especially when combined with the details and intricacies of insurance. Payment for most healthcare facilities depends on how swiftly and accurately they process insurance claims. Efficient handling of insurance leads to better claim processing. It also reduces the administrative burden of high-volume paperwork and record-keeping.

Simplification of the medical billing processes is not just an option, it is a necessity for healthcare businesses that want to stay sustainable and thrive in a competitive environment.

According to reports, the average rate of claim denials in the healthcare industry is between 5% and 10%. To maximize claim reimbursement revenue, providers should ensure their claim denial rate is around 5%.

Diligent record-keeping can be a first step towards simplified and accurate medical billing.

Simplify claim processing Infographics
  • Maintain up-to-date records.

Efficient claim processing requires reliable, accurate medical records. Automating select processes, especially during registration, can help create and maintain reliable records. Outsourcing medical billing can help DMEs/HMEs identify areas that need automating. An outsourcing partner can also deploy the kind of automation required.

  • Ensure insurance information is complete.

Incomplete or incorrect information can lead to claim denial. Automation software can help with accurate recording and more importantly, accessing stored records when the need arises. This helps ensure insurance information is complete.

  • Identify what is contained within insurance.

Efficient claim processing requires complete information including the medical procedures authorized by insurance. Before submitting, consider items such as whether a particular therapy is covered or if certain drugs are off-limits. It is important for healthcare providers to get clear authorization if there is a plan for healthcare equipment to be purchased. Lack of correct authorization can lead to delayed claim processing.

  • Review the insurance provider thoroughly.

If insurance providers are out of state or outside of a specified network the claim can be denied. Reviewing insurance provider information prior to authorization is vital to ensure that claims are not denied and payments are not delayed.

Accessing help: Human resource benefit of outsourcing

Assessing and reviewing insurance details is a time-intensive task; it needs a dedicated resource. Outsourcing can enable startups and small DMEs/HMEs to access high-quality assistance, without investing in expensive infrastructure or staffing. With daily critical data management covered, the small business can focus on providing healthcare to clients and generating new business and revenue.

What’s Next?

  • Choose the right medical billing services to access relevant financial assistance, infrastructure, and expertise to empower your DME/HME to continue focusing on providing quality healthcare.
  • Email us at or call us on 781.503.9002 for a free session.
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