The first improvement I would recommend in the front office processing is ensuring that there isn’t any missing information or incorrect patient demographics data since this is one of the top reasons payers denial claims (Xtelligent, 2019). The most crucial key is making sure that the front end verifies patients’ information, including insurance verifications, and knowing what you’re going get paid before the patient gets there (Sanborn, 2020). Creating a customer service environment and having conversations with patients regarding what they owe or what they need to pay before their arrival and giving the payor information regarding co-pay and deductible amounts. The process of using add-in tools to help reduce phone time as well as registering with payer portals. Another thing is ensuring that front-end staff adequately trained. They need to understand their role and have the right tools to do their job. Also, establishing medical necessity, or getting automatic prior authorizations, benefits verification, patient registration can significantly improve revenue cycle efficiency. With the right technology, you can prevent care delay, claim denials, and other back-end problems.
Which will help staff have more free time to focus on boosting revenue, such as planning additional appointments and patient collections (Xtelligent, 2019). Educate your staff on different health plan structures and understand high deductible plans and off-setting HAS, MSAs. A great tool to see an area of improvement would be using the (KPI) key performance indicator, and this will measure days in total discharge not billed, clean claim rate, denial rate, and case-mix index (Casto, 2018). KPI also has some more critical tracking, such as percentages of patients with public vs. private insurance and patients without medical insurance (WRS, 2020). Furthermore, tracking medical billing and coding is one of the most time-consuming tasks handled in medical offices; this is where many costly errors occur (WRS, 2020). KPI is a powerful tool to use since it takes complex business factors.
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