Another simple opportunity to boost profits is learning how to correctly bill medical. This can be overlooked by many doctors because it’s not as interesting or “sexy” as getting a new piece of equipment or launching a new marketing campaign, but it can have just as much of an impact on your profits.
The #1 thing we recommend for learning how to bill medical correctly is to simply invest some time into it. Be more intentional with your time between patients and hop into forums and industry resources that delve into this topic. You’ll acquire a ton of knowledge that will significantly boost your average profit per exam.
This particular topic could justify an entire guide of its own, but we’ll do our best to put you on the right path with the next few paragraphs. If you want to dive even deeper, we have a significant amount of members-only training devoted to basic and advanced medical billing strategies that’s available to anyone with a free Pivotal Group account.
Improving Medical Billing Practices: Where to Begin…
At a high level, we recommend familiarizing yourself with every step of the process:
- Getting the insurance card.
- Verifying benefits correctly.
- Understanding those benefits.
- Performing the exam.
- Applying the patient’s benefits to the visit correctly (can be very nuanced).
- Making sure to understand what the patient owes you before they leave.
- Coding the visit correctly with insurance for maximum reimbursement.
- Evaluating whether the claim was successful or unsuccessful.
- Proper resubmission to make sure you get paid for your efforts.
There are opportunities for optimization at almost every stage that can make a big difference. One of the best things to do to familiarize yourself with these opportunities, in addition to what’s recommended in the previous section, is to become extremely involved with the billing process so that you know it from front-to-back.
Just like we recommended for maintaining your own bookkeeping (even temporarily), familiarizing yourself with the billing process will give you a much-needed pulse on what your practice’s processes currently look like. This also gives you a baseline of recent performance that can be used to prioritize and implement improvements.
Some of the opportunities you’ll likely discover are:
- Learning modifiers,
- AR billing best practices,
- Using appropriate CPT codes,
- Looking at EOBs,
Again, one of the best ways to improve your medical billing practices is to hop into active independent OD communities, learn everything you can bit-by-bit, and ask for help when you need it.
Don’t forget to start with Pivotal Group’s members-only training (linked above) if you have access to it.