By: Christi Arnett
Communication is a key component impacting the success of your practice’s revenue cycle. Communication occurs between patients, providers, billers, RCM partners, and insurance companies. Poor communication habits between any of these parties can negatively affect the revenue cycle and cause delays in billing and payments. Knowing where some of the common communication pitfalls happen will help you sharpen up your processes and avoid revenue loss caused by ineffective communication.
5 Communication Pitfalls Impacting Profits In Your Eyecare Practice
Vague Language
Clear and well-organized medical records are essential for accurate and complete billing. Vague documentation can lead to errors, omissions in billed fees, and unspecified diagnosis codes—often resulting in claim denials from insurance companies. Furthermore, unclear explanations of benefits (EOBs) can make it difficult for patients to understand their financial responsibility and coverage. The use of medical jargon can also create confusion for patients who are not trained medical professionals, further complicating the billing process.
Failure to Follow Up
Delayed or missed payments often occur when claims are not actively monitored or tracked. If rejected or incomplete claims go unaddressed, billing errors can arise, and opportunities to submit corrections or appeals may be lost. Regular accounts receivable (AR) reviews help identify missed denials and errors, while tracking claim statuses and setting follow-up reminders ensure timely resolution of claim issues.
Inaccurate Documentation
Ensuring all patient demographics and insurance information in the electronic health record is accurate is essential for proper billing. Scanning all relevant insurance and patient paperwork into the electronic health record is crucial to be able to quickly address claim denials or requests for additional patient information from insurance providers. Complete and accurate documentation protocols should be implemented and consistently followed. Additionally, these details should be verified at check in to help confirm accuracy.
Not Addressing Concerns Promptly
Failing to address billing concerns promptly can lead to delayed payments, denied claims, and lost revenue. Regularly monitoring financial and claims data allows practices to identify and correct errors within payment guidelines, ensuring timely insurance resubmissions and reducing the risk of missing critical filing deadlines. Proactively addressing discrepancies not only streamlines the reimbursement process but also minimizes administrative burdens, improves cash flow, and enhances overall financial stability.
Lack of Clarity
Incomplete or inaccurate insurance claims, including missing patient information or unclear diagnosis codes, cause processing delays and require additional time for resubmission. Claims denied due to unclear information require immediate research and follow-up phone calls to ensure accurate resubmission.
Steps to Improve Communication
Providing staff training on clear communication and empathetic patient interaction can improve revenue. It is crucial that staff can clearly explain billing processes and payment options, as well as address any concerns patients may have about their financial responsibility.
Clear communication is essential for a successful partnership with your medical billing company. This ensures timely payments, accurate billing, and proper documentation. By understanding the roles and processes involved, you can establish clear accountability and prioritize effective communication.
If you’re looking to improve your revenue and reimbursements, we’re here to help. Schedule time with our team today to learn how we can make communication easier and set your revenue cycle up for success.