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Medical Claims Processing: Exceeding Expectations

Posted by Infinit-O on Apr 4, 2019 8:00:00 AM

Topics: Outsourcing, Healthcare

Medical Claims Processing: Exceeding Expectations

Patients expect excellent service from healthcare institutions, from diagnosing the illness to processing insurance claims.

The main goal to keep your patient happy is to help your patients save time and money, and improve their recovery experience. While medical coders don’t always meet patients face-to-face, they must still provide positive and meaningful encounters in claims processing, from determining basic information to investigating issues.

At the very least, when you know what the patient wants, you can immediately assess the situation and serve them in the best way possible.

But how do you exceed their expectations in medical claims processing? Here are a few ways to make your patients happy from step one.

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Expert Coders for Expert Service

Medical coders exist to help patients correctly and efficiently acquire insurance claims. To do this, you’ll need a team of highly-trained specialists who are tech agnostic—can adapt to any software your company uses to manage patient information—and are well-versed in ICD-10. At the most basic level, they should know the requirements of claims processing and revenue cycle management.

But it’s not always the case. Many coders cannot always adapt to some 140,000 codes contained in ICD-10, or are easily dismayed when they face an influx of claims. In addition to that, while the US, in general, is experiencing a growth in the number of medical coders, it’s still not enough.

So what’s a good alternative to improve operations?

Consider getting a healthcare solution partner and start with a small dedicated team. As you grow, they can grow with you. Each specialist has complete domain knowledge over their expertise and can adapt to any software that the clients use. You don’t have to worry about training a team, especially in ICD-10, and you’re guaranteed an increase of accurate information and high weekly claims.

Be Efficient in Claims Processing

Access to expertise is not enough. You also have to take into account daily operations that prevent unnecessary backlog that could later be a bigger problem, both for HR and Finance.

A common situation in healthcare businesses is bad documentation or missing information. The coder cannot process the bill properly if there’s not enough information provided, and to avoid further mistakes, the claim may have to return to the provider to give more data.

It’s a tedious process, for both the coder and the patient. In the end, it might result in a rejected claim, and the procedure repeats itself until all information is true and correct.

So, how do you avoid this?

Find the right solutions partner that implement a flexible yet diligent approach to provide correct information and tighten turnaround times, thus eliminating repetitions and needless back-and-forth communications. An ideal solutions partner would have operational excellence, from metrics-intensive plans to simple yet impactful processes that can help you focus on authentic, quality patient care.

After all, the more efficient the claims processing is, the happier you and your patient will be.

Read more: Challenges of Delivering Customer Satisfaction and How To Go Through Them

Rely on an Updated EMR System

There are some healthcare companies out there that think that staying with their current EMR is the most cost-effective decision.

Actually, it may not be.

Beyond looking for an up-to-date EMR system, older hardware may not be as secure as newer ones, and software updates often require operating system upgrades. In short, you need to provide your team with the optimal EMR as well as standard equipment with standard specifications in order to maximize coding efficiency.

What does this have to do with patient satisfaction? Simple: Older EMRs and software may lead to more errors or security breaches, which may lead to an unhappy patient. They expect quick and easy processing, and a tech upgrade would be necessary.

Admittedly though, acquiring new technology may be expensive. To help you curb your expenses, look for a healthcare solutions partner with the right technology that is compatible with your system. Again, that’s where a functional yet flexible approach comes in. The right partner will make sure that not only is your outsourced team equipped with the right hardware and software, but they also meet HIPAA-compliant systems.

Provide Better Safety and Security

This last point is related to the one above, and for good reason.

Patients deserve to have their data safeguarded at all times. They won’t trust a healthcare company who won’t promise them a secure claims process at all times. Your business needs to follow global regulations and standards to ensure your patients’ and stakeholders’ information are safe within a secure network.

At the same time, computers should have up-to-date anti-virus software, and your IT department should have the necessary skills to keep data breaches at bay.

If you’ve chosen to partner up with a healthcare solutions provider, be sure that they’re complying with global standards as well. Most partners are HIPAA- and GDPR-compliant and that their tech is consistently upgraded to meet your standards. Most solutions partners are backed up with ISO certifications, but find the right one that puts security high above in their priority list.

Exceeding patient satisfaction in medical claims processing is as important as helping them quickly heal from injuries and trauma. Avoiding painfully long and repetitive processes is one way to correctly do patient care. With a team of medical coding experts that has access to updated tech resources within a secure network, you’re guaranteed to deliver the best service to your patients in more ways than one.

Infinit-O especially is a trusted healthcare outsourcing partner who can help you build and operate a dedicated team of well-trained healthcare professionals, especially for you and your unique needs. When it comes to healthcare, Infinit-O can meet your goals, whether they be growth, better productivity or simply bottom-line cost savings. With our access to highly-skilled healthcare experts who use cutting-edge technology, we provide some of the best strategic solutions for your business. We are ISO-certified, HIPAA- and GDPR-compliant, so your company’s and patients’ data are safe with us.



When you’re ready to grow, think Infinit-O!


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