Optimize the Medical Billing Process with NextGen

The medical billing experience frequently causes frustration among patients and healthcare workers. Revcycle Intelligence reports that 33 percent of patients are unhappy with the lack of improvement in this area. Optimize the medical billing process to make a significant impact on employee and patient satisfaction along with revenue capture. Here are five ways to deliver modernized systems and processes.

1. Use Solutions with Built-in Preferred Payer Support

Manually submitting claims to insurance companies and other payers take up a lot of your staff’s time and can take longer to get your claim paid. Claims may be lost or lack the right information needed for processing. Practice Management (PM) software such as NextGen Enterprise PM can connect you with your preferred payers and allows you to send the necessary patient data easily. You reduce the time you spend waiting for claims to be processed and the chance that they get denied.

2. Automate the Billing Workflow

You can automate many parts of the billing workflow with NextGen Enterprise PM. When you reduce the manual work needed for submitting claims, accepting payments, sending out reminders, and other critical tasks, your staff has more time to follow-up with missing payments, stay on top of the collections process, and focus on other duties. NextGen PM offers a few functions to assist in the automation of billing workflow:

• Eligibility Verification – systematically check eligibility in batches for patients days in advance. Your team can work the list of ineligible patients before they come into the clinic, saving check-in time at the front desk and ensuring that claims will not be denied for eligibility.

• Claim Edits - these allow for claims to be scrubbed and corrected before they are sent to insurance. Setting up rules for each payer makes sure errors are fixed ahead of time and that only clean claims go out the door. These rules can also be set specialty-specific, so you can configure it to work with your unique practice needs.

• Worklog Tasking – automate creation and assignment of tasks to users and groups in your practice based on predefined criteria.

• EDI Services – using services like NextGen EDI Services can allow you to send statements and collection letters to your patients without having the burden of printing, addressing, and stuffing envelopes at your office.

• Integrated Merchant Services – integrating merchant services with NextGen PM allows front desk staff to simultaneously collect a copayment and enter the transaction in the patient encounter. Integrating merchant services with NextGen Patient Portal will allow the billing office to send eStatements to the patient who can then make payment 24/7 via their patient portal.

An automated billing workflow reduces the balances and refunds you deal with and eliminates many inefficiencies that frustrate patients and staff alike. Everything is centralized, which makes it easy to send statements, check on payments, view a patient’s payment history, and look up collections.

3. Confirm Insurance and Cost Before Service

Unpaid bills can occur for many reasons, such as a patient’s insurance not covering a procedure or the patient underestimating how much the service costs. You can address both of these issues before they step through the door or log in to their telemedicine appointment.

A workflow where the patient demographics and insurance information are entered into your Practice Management system before the patient's first visit gives your office time to run eligibility checks and work out any referral or eligibility issues before their appointment. Knowing the patient’s primary insurance payer will also allow you to create cost estimates for patients before an upcoming procedure. By reviewing the eligibility information along with the typical contracted billing rates for a procedure based on the patient’s payer, you can educate the patient on what their expected out of pocket costs might be so they don’t end up with a surprise bill. You can also set the patient up on a collection plan in NextGen PM before services are rendered. Many offices use this information to collect an upfront deposit for a procedure so that they spend less time trying to collect after the insurance pays.

Your staff will be able to reduce the time they spend handling upset and irate patients in-person, online, and over the phone. The lack of transparency for healthcare costs also contributes to patients putting off essential procedures, which can lead to significant health issues. By improving access to cost estimates, making an informed decision is easier.

4. Analyze Reports to Understand Issues with the Medical Billing Experience

If you have an inefficient medical billing system or workflow in place, you may not know where to start with improvements. Overhauling the entire system all at once is not always feasible, especially if you have significant investments in your current infrastructure. Identifying the areas that benefit the most from these upgrades allows you to roll out new features and software over time.

Use your billing data, staff, and patient feedback, and other analytical solutions to gain a deep understanding of the current billing process. You want to know your baseline statistics so you can track whether changes have made billing better or worse.

As you optimize your systems over time, you should frequently return to these reports and continue looking for ways to improve. The changes may be less drastic as you move to the top of the curve, but there are always innovations in the future.

5. Use the NextGen BBP to Optimize the Medical Billing Process

One of the most powerful tools in the arsenal of NextGen Enterprise applications, is the Background Business Processor (BBP). The BBP allows administrators to create automated jobs for common processes that can be time consuming when done manually. Here are some examples of jobs that can be automated via the BBP.

• Generate claims

• Export a report to an email distribution list, share to a network path, or send to a printer.

• Create patient statements and send to a printer

• Run patient eligibility inquiries in batches for an entire date-of-service

• Print recall plan or budget plan letters

• Batch adjustments and posting

• Import files from a network directory to be files in a batch

• Run patient merge jobs after hours to minimize system slowness

By automating these jobs, you free up time for your billing team to focus on more important tasks. And your team can work with assurance the job will be done by setting up notifications so you're notified of successful job runs or if a job fails and needs your attention.

TempDev Can Help You Optimize Your Billing Process

Optimize your medical billing process so the experience isn’t a nightmare for your patients and staff. By spending the resources required to optimize your billing processes and systems, you end up with satisfied patients, happier staff, and a boost to your revenue. Need a billing experience makeover? Contact us today to discuss a review and optimization of your billing process.