4 Tips for Boosting Medical Billing Reimbursement

Speed and accuracy. What all medical practices and billing companies strive for, which seems to be the opposite of healthcare reform with the introduction of time-consuming value-based compensation models. On top of that, failure to stay up to date with billing rules and regulations result in major billing errors, which means less revenue and unhappy patients. So, how do you avoid these billing errors and accelerate your collections performance? Here are 4 medical billing tips that will boost reimbursement immediately, and yes, they actually work!

  1. Capture the patient-responsible revenue you resolved to write off.
  2. Use business intelligence to identify areas for improvement.
  3. Create hands-free claims generation and submission.
  4. Streamline your collections process with artificial intelligence.

boosting medical billing reimburesement

What is Medical billing reimbursement?

Healthcare reimbursement is the means by which healthcare providers are compensated by either a private insurance company or through government payers for services or procedures rendered. Unlike most service industries, healthcare providers are often compensated months after a services is performed. The amount reimbursed for said procedure is determined by it's ascribed CPT code, the patient's co-pay, and the agreed upon amount in a payer's contract.

Capture the Patient-responsible Revenue you Resolved to Write Off.

Unfortunately, the vast majority of patients don’t have a clear understanding of how their health insurance coverage works. In a recent survey taken by over 2,000 Americans, only 4% of respondents could define all four common health insurance terms: deductible, coinsurance, co-pay, and out-of-pocket maximum. With such limited understanding of health insurance, the chances of collecting on patients is drastically reduced. However, arming yourself with the right tools will allow you to identify the correct insurance coverage which can be applied to a patient visit for payment. ImagineDiscovery™ checks for patient coverage that can be applied to their previous claim, then identifies incremental revenue from insurance for patients who may not have had (or didn’t understand if they had) coverage at time of service and from A/R that is going to be written off.

Use Business Intelligence (BI) to Identify Areas to Improve Medical Billing Reimbursement.

The best way to make informed data-driven decisions about medical billing management is through a business analytics tool. BI allows the user to run custom reports to assess financial performance from every angle of the business, from collection rates to staff productivity. Through business intelligence, billing companies can also give their clients insight into how their practices are performing and where there is area for improvement. By reviewing data, you can set realistic expectations and develop ways to meet goals. Data is solid and reliable, so you know you can make accurate decisions.

Create Hands-free Claims Generation and Submission.

How many hours could you save in staff time if your claims processing was completely automated? Especially for billing companies who bill multi-specialty, it’s impossible to be time or cost-efficient in manual claim submission. With an automated claims processing workflow each step is hands-free including charge coding, checks against payer rules, and submission for payment. Staff members are given much more functionality and can shift gears to focus their efforts on other responsibilities.

Streamline Your Collections Process with Artificial Intelligence.

Think about how much time and money you spend attempting to collect on patients compared to how many actually pay their bills. If you’re not segmenting your patients according to their propensity to pay and customizing the collections process around that information, you should be. There are medical billing AI applications that customize a patient’s statement cycle depending on whether the patient is eligible for the primary insurance listed on the visit before you send a claim to insurance. Based on that information, the application customizes the collections process and even provides alternative payment methods for financial aid. This helps reduce denials and the number of statements sent to patients. With a little luck, these medical billing tips will give you the edge you need to avoid unnecessary billing errors and accelerate your collections.

Medical billing reimbursement is much more than patients paying their bills. It is a critical component of your company’s cash flows. A good system for medical billing is also essential for avoiding costly errors. Applying any of the medical billing tips discussed here can help you improve your medical billing process.



As a long-time writer and content marketer, Jenna Tropea covers a wide range of topics from patient engagement to healthcare policy and regulations. Jenna received her MBA from Clemson University and currently serves as Online Marketing Strategist to ImagineSoftware.

You can contact JENNA TROPEA via email at jtropea@imagineteam.com.