Billing Review Checklist for New Medical Practices

When starting a new medical practice, managing billing can feel overwhelming. A smooth billing process is essential for keeping cash flow steady and avoiding errors that could delay payments. Below is a checklist that can help you set up a solid billing foundation right from the start.

1. Verify Patient Information

Accurate patient information is the first step to ensuring a smooth billing process. Before submitting claims, always double-check patient details, including personal and insurance information. This helps avoid any confusion or claim denials later on.

2. Use Accurate Coding

Using the correct codes for diagnoses and procedures is critical. It’s important to stay updated on coding changes and make sure that every service is properly documented with the right codes. This reduces errors and claim rejections, helping your practice get paid faster.

3. Set Up a Payment Posting System

Creating a straightforward system to track payments will help keep things organized. Whether payments come from insurance or the patient, accurate posting helps ensure that your records stay up to date and that any outstanding balances are addressed promptly. Key Steps:

Post all payments promptly, both from insurance and patients.
Keep a record of patient payments, co-pays, and insurance reimbursements.
Reconcile payment records regularly to ensure nothing is missed.

4. Check Insurance Coverage Before Services

Verifying insurance before services are provided can save a lot of time and frustration later. By checking eligibility in real-time, you can confirm the patient’s coverage and avoid issues with unpaid claims.

5. Communicate Payment Terms Clearly

Setting clear payment terms upfront is key to avoiding confusion. Ensure patients are aware of their financial responsibilities, including co-pays and deductibles. If needed, offer flexible payment plans to make it easier for them to pay off their balances.

6. Follow Up on Claims Regularly

Once a claim is submitted, keep an eye on its progress. Following up regularly helps identify any issues early on and allows you to address them before they turn into bigger problems. Key Steps:

Track claim status regularly to spot any delays or rejections.
Follow up with insurers on claims that have been pending for a long time.
Respond promptly to any requests for additional information or documentation.

7. Train Your Team

An educated team is the backbone of an efficient billing system. Make sure your staff is trained on the latest billing practices, coding standards, and insurance policies. This ensures smooth operations and reduces the risk of errors.

Get Support from IPIRCM

If billing is taking up too much time, or if you want to improve your revenue cycle management, IPIRCM offers expert services to streamline your billing process. Visit IPIRCM.com to learn more about how we can help your practice.

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