Optimize Your Nephrology Billing Services ; Leave No Room For Revenue Leakage

optimize your nephrology billing services ; leave no room for revenue leakage

Noticing constantly declining reimbursements, a decrease in cash flow and profitability? There are several areas in the nephrology billing services, where such leaks may occur. 

It’s a total misconnection that only a major loophole in the billing system can cause a medical practice to lose money. Sometimes, a steady drip of even slight cracks in any one of the RCM tasks i.e. patient scheduling, data collection, medical coding, claims submission, follow-up, denial management, payment posting, medical accounts receivable recovery etc, can lead to major issues. 

Neglecting the minor issues can put your nephrology practice into a critical financial crisis. Failure to detect and plug the revenue leaks can have a significant impact on your practice’s profitability and solvency.

After improving the patients’ lives by providing them standard medical aid, the primary objective of every healthcare provider is to be compensated appropriately for the healthcare services you provide. 

Because the financial stability, sustainability, and long-term survival in the rapidly growing healthcare market are highly dependent on your ability to streamline the healthcare revenue cycle management.  

But in this challenging era, healthcare providers are losing tens of thousands of dollars due to billing deficiencies and mistakes. It has been observed that some healthcare practices witness a rate of claim denials of more than 10%. Which is quite dreadful for healthcare practitioners.

Before implementing the proactive strategies to streamline the nephrology billing services, consider these tips for staying on top of your business processes:

  • Conduct regular meetings with the administrative staff to review progress reports.
  • Have financial benchmarks.
  • Compare the financial health of the current year with the previous one.  
  • Compare your reputation and patient base with your competitors. 

Tips to Add Value to Billing Process

No doubt, due to the growing complexities in revenue collections management, claim denials have become a common phenomenon in medical practices. 

But if the denial rate exceeds the specified limits i.e. more than 5%, then you have to face critical financial challenges. Such as a pile of denied claims, revenue loss and cash flow disruption. Which negatively impacts the bottom line as well as the success of your healthcare business as a whole. 

Are you struggling to keep your claim denial rate minimum to elevate the profit margins of your practice?  Here are the following nephrology billing solutions that can help you to eliminate the problematic areas in the nephrology billing services and better ensure optimal payment capture.

Up-Front Financial Counseling And Collections

Co-pays and deductibles play a crucial role in streamlining the cash flow of medical practices. But unfortunately, nephrologists face immense challenges in collecting payments from patients. 

There may be certain reasons behind this problem such as; failure to collect payments at the time of healthcare services provided, outdated payment methods, untrained registration staff, and absence of clear terms and conditions regarding patients’ financial responsibility. 

Additionally, if your front desk staff isn’t contacting patients before the date of treatment to inform them of their financial responsibility. Then chances are that your patients will not be prepared to pay their dues when they arrive for the medical care services. 

Moreover, it’s your responsibility to inform your patients about the total payments of the treatment or surgeries they are going to undergo. In this way, they will become more clear about their copays and prepare themselves for whether or not they can afford the services. 

Moreover, it is the first and foremost responsibility of the front-end staff to inform patients about all payment types available (e.g., cash, debit, credit card, medical credit company). 

The best tip to maximize the payment collections is to stop using traditional payment methods. You should introduce more flexible options, so that patients can pay their liabilities without facing any problems. 

In addition to this, make sure that your front desk staff collects accurate patients’ demographic information. Because most of the claims are being denied due to the errors in this information. Which ultimately slows down the nephrology billing services. 

Code It Right 

Medical coding is the crucial component of nephrology medical billing services. Because coding errors can impact your healthcare facility financially and put you at risk for non-compliance. 

Insurance claims containing medical codes that fail to describe the patients’ diagnosis, injuries, treatment, medical equipment and services, get denied or paid partially.  

In addition to this, some coding errors like; using the medical codes for more or less expensive medical procedures than actually performed, can put your healthcare practice at legal risk. 

So, in order to streamline your nephrology billing services and save the healthcare business from further financial loss,  medical practitioners should only rely on well-experienced and AAPC-certified medical coders.  

By acquiring the assistance of highly trained coders and providing them with necessary reference materials (e.g., coding editing software, current CPT, ICD-10 and HCPCS books), you can prevent claim denials due to coding errors. 

Furthermore, to catch potential errors and malpractices, you should conduct regular audits to check the compliance and accuracy of the billing and coding procedures. 

Don’t Overlook Timeline For Claims Submission 

Timeliness is the most important aspect of revenue collections management. Every insurance company has its own time frame for submitting the claims.

Most of the time claims that are being submitted after expiring the filing limits, get denied.  To ensure the timely and faster processing of medical claims, make sure that your billing team is filing the claims in a timely manner. 

Apart from this, it is the responsibility of the medical billers to scrub the claims before submission to the payers. In this way, they can set the claims free from errors, which can later result in claim denials. 

Outsource Nephrology Billing Services

The ongoing pandemic has increased the financial burden of the healthcare provided and more importantly has completely changed their working schedules. They find little to no time in managing their non-medical obligations effectively. 

Therefore, the trend of hiring a professional nephrology billing company witnesses a surge. Collaboration with the billing service providers can help you in the following ways: 

  • You gain access to highly trained nephrology billing experts. 
  • Eliminate the excessive burden of complicated RCM tasks and enable healthcare providers to focus on their core aspects i.e. patient care. 
  • Helps healthcare providers to save a significant amount of money on capital costs. 
  • Reduce billing errors and prevent claim denials.
  • Maximize revenue collection. 
  • Optimize medical accounts receivable collections.

Looking to maximize collections or improve your first-pass resolution rate? Then let Medcare MSO handle your nephrology billing services. It’s a multi-specialty medical billing company in the United States. Our industry experts provide your practice with a plan customized to handle all your billing needs. For further information, visit to our Website