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6 Strategies to Prevent Medical Billing Denials

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  Insurance companies deny medical bills submitted for reimbursement by providers at a rate as high as 20 percent. According to the business journal Revcycle Intelligence, the American Academy of Family Physicians reports an  average medical billing denials rate  of 5 to 10 percent among family practice providers. Each denied claim represents lost provider income and time as the billing department must resubmit the claim or forfeit reimbursement. In 2017, Becker’s Hospital Review estimated that a 300-bed hospital could lose up to $3 million in annual revenue with a single percentage point increase in  rejected reimbursement claims . Medi c al practices, hospitals, and health systems can dramatically decrease billing denials by identifying the most common reasons and making procedural changes accordingly. In 2021, the Healthcare Financial Management Association (HFMA) reported that about  90 percent of denied claims  are preventable, representing more than $...

The Evolution of APIs in Healthcare

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  If you work with healthcare data, you rely on application programming interfaces, or APIs. These systems facilitate data transfer among multiple digital databases and programs. For example, an API can trigger the update of a patient’s electronic health record (EHR) or produce regular reports about scheduling, payments, and other administrative functions. When a provider enters patient details into an insurer’s API, the program provides instant policy coverage information. Exploring the evolution of APIs  i n the  context of healthcare data  allows professionals to better understand how these systems function and take full advantage of their capabilities. As we prepare for the new data provisions of the 21st Century Cures Act, which mandates secure, seamless sharing of healthcare information among practices, APIs will become an even more integral part of the practice landscape. The Basis of Care Coordination As patients visit multiple primary and specialty care prov...

How to Improve Client Satisfaction With a Flawless Onboarding Experience

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  Your company has an awesome service. Your existing clients are, hopefully, “happy campers.” Why? Because your onboarding experience is unique, flawless, and responsive to each client’s needs. The transition from onboarding to “satisfied long-term client” is smooth, leaving the client with the sense that their business is better because of the successful and ongoing relationship you have facilitated. Getting a new client to say “YES” is just the beginning If the next steps in building the client r e lationship fail to create confidence and trust, buyer’s remorse may be knocking at your door. It’s easy to think that buyer’s remorse is about the purchase of a car, a house, or a designer purse or outfit on a now regrettable whim. But a new corporate client can experience the same type of regret or remorse. It’s important to remember that the person who agreed to this new arrangement put their assessment of the value of your services on the line with their higher-ups. If the onboardin...

Patient Billing Preferences by Generation

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Does your practice offer customized patient billing options to support various demographic preferences? Understanding how each generation prefers to receive and communicate regarding payment statements and other key documents can potentially boost your ability to collect client balances. Reviewing the Research on Generational Patient Billing Preferences While many healthcare practices assume that paper is paramount for seniors and digital drives payments by millennials, the research we explore below provides insight beyond these basic assumptions. The data on digital patient billing According to a 2020 study, patients across all age groups have increasingly  opted into digital notifications . The researchers used these generational categories developed by the Pew Research Center: Gen Z (1997–2003) Millennials (1981–1996) Gen X (1965–1980) Baby Boomers (1946–1964) Silents (1928–1945) Study data indicated that all but one of these groups receive 48% of patient billing notifications b...