Smart Medical Billing
Revenue Optimization
Mebilling’s Revenue Optimization Team Safeguards to Intact the Supreme Stage of Success
Retained & Expended Revenue Optimization
The Revenue Optimization team at Hsrrevenue Billing is dedicated to excellence, ensuring sustained financial growth and maximizing revenue. We go beyond conventional methods, analyzing modern procedures from multiple perspectives to identify the most effective strategies for revenue enhancement. Our commitment is to provide employers with the highest level of satisfaction through innovative and results-driven solutions.
With a thorough understanding of state regulations, our Revenue Optimization team carefully evaluates every aspect of the revenue cycle. From demographic entry and medical record coding to claim submission, payment posting, and denial management, we work closely with our clients’ staff to develop and implement tailored strategies for both front and back-office operations. The successful execution of these plans not only strengthens financial processes but also leads to increased cash flow and optimized revenue.
Why Our Optimization Program is Significant
Hsrrevenue Billing proposes its Revenue Optimization Program in contradiction of the below indications
Inefficient Accountability
A robust and highly effective check-and-balance system is essential to ensuring transparency and seamless operations in practice management.
Difference between Charge & Paid Amounts
Significant discrepancies between billed and paid amounts can negatively impact the reputation of the billing agency.
Unpredictable Cash Flow
A steady cash flow is essential for the successful operation of a practice. Achieving this requires technically proficient medical billing to ensure smooth and efficient financial processes.
Ineffective Claim Follow-through
Receiving repeated denials indicates ineffective claim follow-ups, suggesting that issues are being overlooked rather than properly addressed.
Excessive Denial Rate
A denial rate of 10% or higher is a clear indicator that medical billing processes need improvement.
Lag Submission of Claims
Every insurance company has its own Timely Filing Limits (TFL). To prevent claim denials due to late submissions, it is crucial to ensure compliance with these deadlines.
Payment Posting Holdup
Delayed payment posting negatively affects the transparency of practice outcomes and creates challenges in identifying upcoming denials.
Excessive Medical Documentation
If payers repeatedly request supporting medical records to validate treatments, it indicates that the submitting party’s documentation was incomplete.
Fundamentals of Optimized Revenue
Hsrrevenue Billing has its strategies to upkeep the revenue at an optimal level. Brief Summary is here!
Claim Examination Before Submission
Hsrrevenue Billing claim production team follows strict SOPs to identify and correct errors before submitting claims. These errors may arise from demographic entry, pre-authorization, eligibility and benefits verification, or coding edits. Our proactive approach ensures accuracy and compliance from the start.
Flawless Claim Submission
Once claims pass the initial examination, the Hsrrevenue Billing team formats them using the appropriate billing form (CMS-1500 / UB-04). Claims are then submitted electronically via EDI format. In cases where a payer does not accept electronic claims, paper submissions are processed accordingly.
Claims Tracking & Follow-Up
After submission, Hsrrevenue Billing implements a structured tracking system to monitor claims at every stage. We ensure that each claim has a primary receipt from the payer and follow through until payment is received. Our advanced mechanism detects denied claims, which are promptly reassigned to the AR Follow-up team. This team works diligently to recover the maximum possible payment.
Accounts Receivable & Denial Management
Payments are accurately posted to the corresponding patient accounts. Unpaid and underpaid claims are escalated to the technical denial management team, which identifies and resolves issues before resubmitting them for reprocessing. Meanwhile, our AR team negotiates with insurance companies on low-paid claims, submitting reconsiderations and appeals to secure rightful reimbursements.
Performance Analysis & Revenue Optimization
Hsrrevenue Billing employs dedicated analysts who continuously monitor revenue cycle activities, providing valuable insights to enhance efficiency. By tracking performance at each stage, they identify weak areas and suggest improvements. Their detailed reports offer a transparent overview of the organization’s financial health, ensuring continuous optimization of the revenue cycle.