Challenges Associated with Medical Billing

Medical billing is a complicated function, more so for DME businesses handling multiple client requirements. There are multiple challenges at different stages, including training, revenue cycle management, and denial management. Below we list some challenges DMEs/ HMEs face in medical billing.   We also mention some solutions to address them effectively without affecting the business bottom line.

Dealing with high attrition rates

Medical billing is complex in terms of the information and data required and the need to maintain high accuracy of information. This means documents must be accurately scrutinized and the insurance information provided verified. Apart from collecting and recording accurately, the onus lies on the DME to ensure the information contained in documents provided by patients is accurate and reliable.

For DME businesses of any size, this can be tricky to navigate, particularly since the resource pool remains the same. The same employees need to ensure the business continues running smoothly. This leads to faster burnout and high turnover. The complexities of medical billing can add to a feeling of burnout, especially when combined with the furloughs and layoffs resulting from COVID-19.

Action item: For any business, curtailing a high attrition rate is essential, both from cost perspectives, as well as to break the cycle of hiring and training, only to lose the resources.

A constant cycle of hiring and training

High burnout and attrition translates to frequent hiring, one of the several challenges DME businesses face in medical billing. Not only is this detrimental to the business economics, but it also hurts the goodwill earned by the business and, eventually, potential business prospects.

To ensure accurate medical billing and claim application, most DMEs must invest in staff training. The claim application process is critical to timely payments for DMEs; any inaccuracies in the claim application can lead to delays and sometimes an outright denial of the payment.

Persistently delayed claims reflect poorly on a business; they can deviate from the designated business budget, throw forecasts off track, and affect DME sustainability.

Action item: Leveraging professional expertise for RCM services can ensure timely billing and a streamlined claim application process. Outsourcing medical billing can help streamline revenue cycle management without compromising on existing business deliverables or assignments.

High operating costs

Consistently high operating costs can result from poorly managed processes, high wages and benefits for in-house resources, the need to set up and manage infrastructure, and the need for effective revenue cycle management. These affect overall business operations, leading to rising costs, yet not necessarily efficient processes.  Low collection rates impact financial management, leading to consistently high expenses without supporting income.

Automating key revenue cycle management elements is an option. Still, technology adoption needs to happen rapidly and in a trustworthy manner for a DME to begin to derive benefit from it. Furthermore, technology adoption is not a one-time investment. It requires consistent support and upgrading to work efficiently.

Action item: Driving process efficiencies is central to a growing business, and automation is an excellent way to achieve this. Efficient processes increase productivity and result in better resource utilization and more robust financial management. An outsourcing partnership for medical billing services can provide businesses with ready access to technology, minus the costs associated with in-house setting up and maintenance of these systems.

Next Steps 

-> A DME partnership can provide the right assistance and expertise to manage DME/HME billing requirements reliably, such that business profitability receives a boost. Learn more about our medical billing at https://analytixhealthcaresolutions.com/ 

-> Email us at sales@analytix.com or call 781.503.9002 for a free session. 

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