New ICD-10 Changes May Negatively Impact Revenue Cycle Management

Revenue cycle management starts when the patient makes an appointment with the doctor’s office. Then when they come to the visit, they usually pay their co-pay and the office then files a claim for the service. The cycle ends when that claim is paid.

Unfortunately, this cycle has a lot of bumps and problems along the way from the appointment to payment. With the recent changes in the ICD-10 codes, many doctors’ offices aren’t prepared for how the changes will affect their revenue. Already a difficult process, the new changes could adversely affect a doctor’s revenue even more than before. There are several mistakes that are made that can easily be remedied by outsourcing your billing to a professional medical billing company who can make the Revenue Cycle much easier to deal with.

Denied Claims

One mistake made on a medical claim can have the entire claim denied, not paid, and have to be fixed and resubmitted. This wastes a lot of valuable office time and often, the medical office staff has to speak with or send letters to the insurance company to figure out the problem. These tasks are very time consuming and it would be much easier just to get the claim paid the first time around.

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One article estimates that even a successful billing office usually has a rejection rate of 10 percent for claims when they’re first submitted. That means that offices with billing problems are spending way too much of their time on resubmitting claims. If your office spends too much time on filing medical claims, consider turning your billing over to a medical billing company. They are experts in what they do and you will see your billing costs decline over time.

Underpayment Mistakes

Many times, claims are filed with the insurance agency, and unbeknownst to the doctor, they are underpaid for their services. Healthcare reimbursement is a very tricky process and people often don’t even realize they are making mistakes when submitting claims. They might not be as trained as they need to be or not familiar with the new ICD-10 codes and the result is an overall loss in revenue.

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These small mistakes can really add up over time and cost your practice a lot of money. A medical billing service cannot only turn your claims around faster, but they will keep on top of your contracts with your insurance companies so you can be sure that you’re not being underpaid for your services.

New ICD-10 Codes Exacerbate the Problem

Most doctors’ offices thought they were unprepared for the new code changes last year and they worried that the new ICD-10 codes would negatively influence their revenues. With the new codes in place, it can make managing your offices’ revenue cycle more difficult and cause billing backups, rejections, and mistakes. Doctors’ offices will have to increase their staffing and pay overtime to keep on top of the changes. The best way to relieve yourself of this headache is to have a medical billing company take over your physician billing so you can relax and know it’ll be done right, the first time.

The ICD-10 code changes make the already complicated revenue cycle even more difficult. The end result is that doctors’ offices are going to have more claims rejected, have more mistakes, and over time, these costs will add up and a decrease in revenue will occur. Revenue cycle management can be a delicate balance and one way to make it easier and see an increase in revenue over time, is to have a professional medical billing company work on your claims so you’re ensured that they’ll be correct.