The payment collection and claims process varies from practice to practice, and the margin for error in preparing claims typically depends on a range of factors, from the complexity of the diagnosis and the services performed to a patient’s eligibility for insurance coverage and ability to cover subsequent costs out of pocket. Without adequate resources and the necessary systems in place, the average practice can begin to lose money the moment a prospective patient picks up the phone to make an appointment.
Industry estimates suggest that most practices can lose out on as much as 30% of potential revenue through weak links and inadequate resources in the claims process chain.
Claims and Revenue – Where Does Your Practice’s Money Go?
Verifying patient insurance eligibility ahead of a visit
– neglecting this step can account for as many as 25% of private payer claims denials, due to patient ineligibility for benefits, or lack of coverage for specific services
– The likelihood of collecting payment drops considerably after a patient leaves, therefore collecting payment at check-in is the best option. Uncollected co-pays can cost your practice as much as $100,000 in lost revenue each year.
Incorrect codes/claims information
– Most denied, delayed, or incomplete payment reimbursements result from three of the most common errors on claims forms:
Incorrect codes and/or modifiers
Incorrect patient or insurance information
Even when claims are approved and paid upon the first submission, it is estimated that as many as one in ten payments is incorrect. With the added administrative burden and further strain on resources that following up on and resubmitting a denied or incorrect claim can entail, an average of 65% of providers decide not to follow up and resubmit denied claims, which can cost a practice an additional $14,600 per year in lost revenue.
Contact a medical billing expert today!
Getting paid for services can be difficult. With the average practice only collecting on 50-70% of outstanding invoices, and the costs associated with patient care on the rise, ML Medical Billing provides the knowledge, expertise, and resources necessary to make sure that your practice collects on every penny owed! Call (888) 719-7602 to learn more about how our services can work for your practice.
Next, try our free online profit calculator to learn more about how ML Medical Billing can maximize your practice’s profits today!