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Key Steps of Successful Medical Billing Revenue Cycle

Due to the complexities of the medical billing revenue cycle, it is challenging to run medical practices smoothly. Similarly, several things may go unplanned and require focus, attention, and expertise to handle the claim life cycle properly. Likewise, it is essential to mitigate the risks of claim denials which constitute revenue losses. So, following the key steps of the billing process accurately leads to timely claim submissions and greater reimbursements.

The billing and coding process needs to be efficient for achieving financial stability. Similarly, healthcare organizations need to get timely payments to be successful in the modern healthcare industry. So, optimizing the revenue cycle process by following the important steps of the medical billing revenue cycle leads to operational efficiency. Efficient revenue cycle leads to greater financial and clinical outcomes. Also, practices can focus on improving the patient’s health and pay attention to core tasks to grow their healthcare business.

Patient Appointment

The first step of the billing revenue cycle management is the appointment of patients. When the patient checks in, the practice must have the demographic information. Also, the insurance payer and policy number are required. Similarly, medical practices should know about the insurance payer before rendering services.

Benefits and Eligibility Verification

To ensure seamless medical billing revenue cycle, the verification of insurance and services it covers should be the primary concern. Failing to do so results in inaccurate claim submissions leading to denials. In addition, medical practices should check with the insurance payers before the visit of the patient to avoid hassle.

Clean Medical Coding

The success of the claim cycle in medical billing depends on the accurate submissions with clean diagnostic and procedure codes. In addition, the coding staff should use proper CPT codes to explain the treatment of the patients. Also, use accurate modifiers to further elaborate the treatment physicians offer to the patients.

Charge Entry

It is one of the important steps of the revenue cycle and this refers to submitting the charges for services rendered to patients. Similarly, updating the medical codes appropriately according to payer and state guidelines eliminate errors. So, keep the medical billing revenue cycle efficient with error-free charge entry.

Accurate Claim Submission

Submitting clean claims on time to optimize the reimbursements from payers is essential to achieve revenue cycle success. In addition, the billing revenue cycle management should be optimal to make sure that practices thrive in the modern healthcare ecosystem. Therefore, error-free claims result in greater reimbursement rate.

Payment Posting

The final step of the claim cycle in medical billing is payment posting. In this step, the billed amount is sent to the payers. Also, the amount owed by the patient is determined in this process. Similarly, payment posting depicts a clear financial picture of medical practices and helps to identify problems or weak areas.

Summing Up

These are the key steps of the revenue cycle which enable healthcare providers to optimize the billing process. In addition, medical practices can reduce claim denials, improve cash flow, and maximize the financial performance with efficient billing. As a result, these key steps of the medical billing revenue cycle constitute the whole process. Further, practices can get healthcare reimbursement 101 training with our experts. Transcure provides medical billing services to small and mid-sized practices helping providers achieve financial success.

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