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Medical billing issues that impact

the healthcare revenue cycle

While technology and payments are reshaping the revenue cycle, effective medical
billing becomes necessary in order to reduce days in accounts receivable. Because
everyone involved depends on the last interaction in the lifecycle of a claim, the
medical billing process can often be convoluted and full of surprises for providers.

Let’s examine several areas that can impact the stages
of a medical claim:

Failure to capture patient information on
the front-end can delay reimbursement

Initial contact with patients begins the billing process.
Obtaining the information at the point of scheduling and
registration is critical in claim submission. The last thing
you want is the claim to recycle itself back through the
organization, thus wasting valuable time and resources.
Corrective action should include educating and retraining
your up-front staff to check each time any services are
performed.

Failure to inform patients of their responsibility
can lead to collection issues

A trend in healthcare that has recently gained in importance has
been the shift in patient responsibility. Patients are feeling the effect
of carrying the financial burden, and that can lead to collection
issues and bad debt. Patients who are covered by government-
sponsored insurances are now in managed care plans, which
requires these plans to shoulder more of the financial obligation.
Providers must meet changing requirements to collect from payers
without compromising how care is delivered, and this creates new
challenges for managing the revenue cycle. Engaging patients in
their healthcare costs and liabilities before care is given can be the
first step towards revenue recovery.