5 Ways To Maximize Collections in Small Medical Practices
How to maximize collections in small medical practices?
Small practice owners or solo providers generally manage medical billing all by themselves.
They juggle between patient care and administrative activities of medical billing. As medical
billing requires medical specialty-wise billing and coding expertise, most of the time, providers
lose a lot of money due to denied claims. They just focus on submitting claims earliest and are
happy to receive whatever payments insurance carriers are making. In this article, we shared 5
ways small practices can maximize their collections with the main focus on patient care.
5 Ways Small Practices Can Maximize Collections
1. Collect Accurate Patient Information
Most of the claims get rejected due to inaccurate patient demographics and insurance
information. Standardize your information gathering process and collect information like
name, address, phone number, copy of the photo ID, and other details. Verify the accuracy of
patient and insurance information using patient portals; billing software; or clearinghouse
software. In case of any changes in the information, update in billing system asap.
Generally, patient information like zip code keeps on changing as patients might have
relocated. Also, stay in touch with your patients and request them to notify your practice
about any changes in insurance or patient information.
2. Focus on Claim Submission
You will be surprised to know that out of all claims submitted by small practices, almost 40
percent of them contain errors. Either rendering provider details might be incorrect or billing
information or missing reference number or an inaccurate number of units. It’s always easier
when you fill all fields correctly the first time. When you submit clean claims the first time, you
will receive reimbursement quickly.
In case the claim got rejected or denied, you have to rework the claim, and if required need to
contact the insurance carrier, resulting in a waste of time and delayed payments. Try to submit
insurance claims as earliest as possible but don’t submit them if you are not sure about any
field in the insurance claim form.
3. Educate Patients on Insurance Coverage
It’s really crucial to educate your patients on planned medical treatments and their insurance
coverage. Most patients are unaware of co-payments or deductibles and insurance coverage
for all processes. Due to changes in market conditions, most patients are buying High
Deductible Health Plans (HDHP), leading to high patient responsibility for any medical visit. It’s
the responsibility of providers to educate their patients on planned medical activities,
insurance coverage, and patient responsibility.
Collecting patient responsibility from a well-informed patient is easier as patients are mentally
prepared to make payments at the time of visit. Using simple flyers or banners to convey
billing basics to your patients is a good technique to speed up the claims processing. You could
also dedicate a special helpline to guide your patients on the payment process. By educating
your patients about the insurance process, you avoid being the middle man in the patientinsurance company relationship.
4. Read ERAs and EOBs
As discussed earlier, most providers doing medical billing all by themselves, are focused only
on submitting claims and ignore the explanation of benefits (EOBs)/ electronic remittance
advice (ERAs). Every insurance carrier provides detailed payment information for every
submitted claim. Single line items from EOBs and ERAs will include payment remarks whether
payment is been made or the claim is being denied with remark code.
When you start reading EOBs/ERAs then you can find how many claims are getting denied and what is the most common reason for claim denial. Whether it’s a patient’s insurance coverage
or lack of credentialing or wrong use of procedure code/modifier or claim not paid due to
unpaid deductibles, reading payment remarks will help you to collect accurate insurance and
patient reimbursement.
5. Use Medical Billing Software
Use medical billing software to submit claims electronically. There are lots of insurance
carriers now, who are not accepting paper claims anymore. There are tons of advantages to
submitting electronic claims and you will require medical billing software to do that. Even for
small practices, there is a number of medical billing software that is charging on a number of
claims submitted. There are various modules of billing software and you can choose based on
your practice requirements. If you integrate it properly, medical billing software helps to keep
track of all submitted claims and also allows you to resubmit denied and rejected claims
efficiently.
As mentioned earlier, medical billing requires billing and coding expertise and consumes a lot
of time. In case of any claim gets rejected or denied, contacting insurance carriers and
reworking such claims consumes a lot of time. Small practice owners or solo providers might
avoid taking assistance from medical billing companies due to high consulting charges but
that’s not the case with us.
In private practice and/or any healthcare business, having the right workflows can be the difference between success and failure, breaking even or making a profit. Picking the right technology for your practice to optimize your revenue cycle management is difficult and here at Trucare, we are all about helping you through that process. As an experienced medical billing and coding company, we not only handle all aspects of your medical billing process but we will help you find the right technology partners that fit your needs and help you optimize your workflows. We will show the case studies and things that are working for other clinicians like you, and keep you up to date with the ever-changing healthcare system. Connect with us to get a free Billing and Coding analysis of your practice.
About Trucare
Trucare is making healthcare more efficient, one claim at a time. We are a state-of-the-art medical billing partner, that helps your healthcare business thrive.
Why Trucare?
Focused: Dedicated Practice Management Specialists
Experienced: Experienced Revenue Cycle Management
Specialized: HIPAA Certified, Speciality Billers
Cutting Edge: Technology Driven — No BS or Redundancies
Resourceful: Always Ahead of the Compliance Curve
Affordable: No client too big or too small. Rates as low as 2.49%.
To learn more, visit or call
+1 888–520–2515
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