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Running a multispecialty center is already a laborious task. We know how difficult it gets. But the challenges and complications in billing make things go haywire. On-time reporting, recording patient details, and ensuring accurate documentation across specialties – a lot goes on behind every billing cycle.
While errors in medical billing already make doctors in the US lose $125 billion every year, it becomes a whole new ball game in a multispecialty center. These give rise to unique billing and claims submission challenges that aren’t present in their single-specialty counterparts.
For instance, we recently heard a story about a multispecialty center, where a patient had come to see a therapist, but then, they were referred to Urgent Care to get an injection and receive further treatment. In such cases, where there is an overlap between the services offered, accurate reporting and billing often becomes a problem.
Urgent Care and other specialties, as we saw from the example above, have different coding and billing requirements. In these cases, inaccurate recording or reporting affects your billing process adversely.
Additionally, the administrative burden of keeping track of patients across specialties while handling their documentation can cause delays in claim processing, increasing the likelihood of claim denials.
Thus, it becomes essential to follow effective billing strategies and have a well-trained staff that can handle the nitty-gritty of multispecialty billing.
Let’s look at the best practices that can help you ensure smooth billing in a multispecialty practice with urgent care, along with different specialties.
1. Effective Categorization
In the above scenario where a mental health patient first sees a therapist and then goes for treatment in Urgent Care, we’re faced with a reporting dilemma. You see, the behavioral issue falls under a different set of codes, while the Urgent Care falls under different regulations. So, when the categorization and reporting don’t happen on time, it leads to confusion and challenges later on in the billing process.
To overcome this issue, it’s crucial to record and register the patient details on time and with complete accuracy. A clear and thorough understanding of the billing and coding requirements of different services under different scenarios ensures appropriate reporting into the software.
Additionally, reporting and billing according to the place of service and the specialty involved is vital to avoid mistakes and enable hassle-free claims processing. This clears any scope of misunderstanding in the payment process.
2. Invest in the Right Software
Having an advanced practice management software fit for multispecialty billing is non-negotiable. The software can simplify your reporting, coding, and billing complexities with automated frameworks.
It helps you verify insurance eligibility, generate customized reports, and maintain electronic health records, all via a single platform. Thus, when choosing your billing software, it’s important to ensure that it has all the features for enabling accurate and efficient billing in your multispecialty.
3. Train the Staff
Your staff plays a key role in ensuring a streamlined billing process. It’s crucial to onboard dedicated staff that understands the nuances of how to manage the billing and coding requirements of different specialties.
But it’s not always possible to find specialized staff for all specialties. In this case, it helps to effectively cross-train your employees to handle the varied requirements of multispecialty billing. Ongoing training can improve the staff’s skillset in handling different billing complexities and staying current with the latest coding regulations.
4. Conduct Regular Audits
Even with a well-trained staff following accurate reporting and effective billing practices, errors and oversight can occur. To prevent these errors from turning into denials or major billing faults, have a regular and strong auditing system in place.
Conducting frequent audits helps identify any discrepancies or errors in coding and documentation, allowing for timely corrections. Implementing corrective measures based on audit findings also helps in reviewing and refining the overall medical billing process.
5. Sign Separate Contracts
Running Urgent Care along with a different specialty — like Primary Care — calls for a thorough understanding of the insurance requirements. For starters, a multispecialty environment requires you to sign separate contracts with insurers for different specialties.
Several medical centers that we, at Lister, work with have such a setup — where they’re enrolled into different contracts with insurers for their Urgent and Primary Care facilities. Signing separate contracts clarifies expectations and eliminates the chances of misunderstandings and disputes.
6. Partner with Experts
Managing billing in a multispecialty is daunting. It requires significant time, investments, and effort to understand the system.
The solution? Outsourcing your medical billing operations to professionals. With their industry experience and in-depth understanding of the system, medical billing professionals can streamline your billing process, minimize claim denials, and optimize your overall revenue cycle.
At Lister, our medical billing experts have helped multiple medical centers like yours eliminate inefficiencies and optimize their billing with accurate coding, on-time claims processing, and always-on, personalized support.
Key Takeaway
Running a multispecialty care center can significantly complicate the medical billing process. But with appropriate, on-time reporting in the right PMS, well-trained staff, and frequent audits, you can ensure accuracy in the billing system.
It also helps to foster a culture of continuous improvement and adaptability within your practice. Regularly updating your knowledge on regulatory changes, leveraging technology for better data management, and seeking feedback from your billing staff can provide additional insights and help fine-tune your processes.
Want our medical billing experts to review your current multispecialty billing system, identify bottlenecks, and suggest best practices to streamline your overall financial health? Contact us today at contact@listerventures.com and get a Free Mini-Audit.
Improve your Claims, Collections and Optimize Your Revenue with Our Complete Medical Billing Services!
Copyright © 2023 Listerventures. All rights reserved | Designed by Spidergems