What are the methods to prevent revenue leakage in Healthcare?

Your practice will experience revenue leakage starting the moment a patient schedules an appointment with you. Some of these leaks typically start out small but overtime they will make large dents within your practice.

Below are some tips to help improve your revenue cycle management system and prevent those leaks.

1. Patient Information: In order to reduce claim rejections resulting due to patient not found, ineligibility and service not authorized, one needs to get the accurate patient information. Implement a checklist at your practices registration office to help insure accuracy. When the staff member registering a patient should verify the patient’s information, take a photocopy of the patient’s insurance card, and review the patient’s insurance (optimally, this would be done before the physician sees the patient in order to avoid performing services that are not covered).
2. Making Patient Accessible: Many practices unintentionally put limits on their ability to be paid by their patients by failing to offer different ways for patients to pay. Try to implement a checklist at your practice registration office to help insure accuracy. Patients might be willing to pay up front until they realize they don’t have the option because their card is not accepted at your practice. Finding ways to help increase collecting the patient’s responsibility up front will help prevent major revenue leakage.
3. Reduce Claim Denials: The most common reason for claim denials include:
4. Patient ineligibility
5. Incomplete patient or plan information.
6. Missing supplemental attachments.
7. Partial service information.
8. Duplicate claims.
9. Claims submitted to the wrong insurance company, and medical coding errors.

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All of these errors could be fixed by implementing a check system. Have someone oversee the claim submissions and denials. Find out what the most common errors are for your practice by taking the time to analyze the denials that come back to you. Finding the problems specific to your practice will help eliminate or reduce your practices denial rate.

If your practice is receiving high rates of denials it might be wise to consider outsourcing your medical coding. This would save your practice money, because you don’t have to pay for the medical coder’s time like you would your employees, but rather the codes they send out. If there happens to be denials they take care of it.

To avoid revenue leakage at your practice make sure to have a check system in place each step of the way, from the moment a patient schedules an appointment until final payment occurs.