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Top Medical Billing Concerns Healthcare Providers Are Facing and How to Overcome Them

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Healthcare providers, in adherence to the medical and healthcare laws in place, face a number of challenges.

Majority of these challenges have to do with the billing part of the process. Something as simple as getting paid for the services being provided remains a matter of concern, taking up a lot of time of the doctors and healthcare providers in sorting it out.

Even after comprehensive systems in place, billing process hasn’t been able to become as swift and smooth as it should be. Let’s take a look at the top three medical billing concerns healthcare providers are facing and how to overcome them:

Collecting deductibles and copayments

Deductible or copayment is the amount required to be paid right at the time that the patient gets the service. It is kind of a down payment for getting the necessary medical procedure done or securing medication. In many cases, patients are unable to pay the full amount of deductibles, which then leads to the healthcare providers contacting the insurance company for getting the rest of the payment. This is a lengthy and tiring process, also wasting a lot of precious time of the doctors.

One way that this problem can be overcome is to establish a clear cut payment plan before providing the service. Checking for the credit card of the patients right before the appointment can be helpful in determining whether the patient will actually be able to pay or not. This requires maintaining such billing management solutions that allow payments to be placed on credit cards.

Getting a go-ahead for uncovered procedures

Insurance plans come in a number of structures and coverage frameworks. One of the main challenges on part of healthcare providers is to approve procedures that have not been covered by the insurance plan of the patient. As such, there is a risk that the payment may not be made afterwards at all. In cases where these procedures are expensive and crucial to b epe4rfomed at the same time, the healthcare providers are faced by a dilemma. They cannot flat out refuse carrying out the procedure, but risk losing their payment if they do.

To overcome this problem, the doctors, collectively with the input from the patients, can come up with detailed payment plan that spans over a period of time so the burden from the patient can be lessened while the payment is also ensured. It becomes easier for the patients when they are given the choice to pay a bigger amount in installments.

In cases when a certain medical procedure is covered but requires pre-authorization by the relevant insurance company, not seeking the authorization can land the healthcare provider in trouble. It is crucial to secure pre-authorization before moving on with the procedure.

Checking coverage

In many cases, patients are themselves unaware of what kind of procedures are covered by their insurance policy, or the insurance policy itself is not clear cut in this regard. Getting on with the procedure without confirming the eligibility with the insurance company can turn into troublesome phase later for the healthcare provider.

As such, it is important that all healthcare providers use such technology that makes it easier to verify the insurance coverage and procedures. Coverage information for each patient should be accessible by simply entering the patient information from the insurance card.

If you are also facing billing challenges specifically among other problems, you should consider hiring a professional service, which will help you automate your systems so that billing and other crucial concerns get easier to sort out.


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