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Medical Billing Best Practices for Holistic Providers

Medical billing and coding are essential to the modern healthcare landscape. As more holistic practices are being credentialed by insurance companies, optimizing the medical billing process is essential for success and growth. Unfortunately, many holistic providers may find the medical billing and coding process overwhelming. The good news is that it doesn’t have to be!

These medical billing best practices can help your holistic practice navigate the complexities of the insurance billing process. Follow these tips for the most efficient and streamlined medical billing and coding experience! 

What is Medical Billing?

When delivering treatments for any insured patients, medical billing is an essential component in the medical reimbursement process. Medical billing is the process of submitting claims with insurance providers so healthcare providers - whether conventional or holistic - can receive their payments in return for their services to the patient. Any medical provider who is credentialed can be reimbursed by insurance companies for services, including private medical practices, hospitals, outpatient facilities, and holistic practices. 

Medical billing ensures that the healthcare provider is being paid for their services by billing both patients and insurance companies so the medical practice can be paid for treatments. Since medical billing ensures medical providers are being paid, any hiccups in the system from denied or delayed claims can negatively affect a practice’s revenue. 

What is Medical Coding?

Medical coding is the translating a patient’s medical history of diagnoses and treatments received into a universal, alphanumeric shorthand used by insurance companies to pay medical practices the correct amount for their treatments. Each medical procedure and diagnosis is labeled with a unique code that is used to determine the payment amount. 

After a patient’s chart has been translated into the correct code, a billing claim is filed to the patient’s insurance company to request the correct reimbursement for the treatments. During this process, insurance evaluates the claims for accuracy; if there are no errors, then insurance reimburses the medical provider and determines how much the patient owes. 

Why Accurate Medical Billing and Coding Is Essential for Holistic Practices

Proper medical billing and coding are key for efficient reimbursement - and successful holistic practice. In general, the financial health of your medical practice weighs on how accurate your medical billing and coding are since consistent errors can be costly. 

Holistic treatments

While every medical specialty needs accurate billing processes to receive payments in return for treatments, holistic practices should take special care of their medical billing. Most holistic practices are smaller than larger medical businesses and therefore have tighter bottom lines. On top of that, holistic practices have unique billing specifications to pay attention to, including regularly changing compliance guidelines and unique uses of modifiers.  

Since medical billing is an integral function of the reimbursement process with a direct effect on your holistic practice’s revenue, the more accurate your medical billing is, the more time, energy, and money your practice will have. Instead of spending time resubmitting claims where even the slightest error can delay payments for weeks, accurate medical billing allows you more time to spend doing what you love - delivering care to your patients. 

Medical Billing and Coding Best Practices to Implement as a Holistic Provider

As a holistic practice, a streamlined billing process is one of the best ways to boost your revenue cycle management. Here are some medical billing best practices to follow to boost your practice’s financial health and avoid costly errors. 

Make Your Medical Billing Statements Patient-Friendly

By making your payments more readily accessible, your billing can be more patient-friendly and easier for patients to make payments so you get reimbursed faster. This includes offering patients a variety of ways to pay for services. 

Keep Your Clean Claim Rate Above 95%

The clean claim rate ratio is the average number of claims paid on the first submission. A 95% clean claims rate means that all but 5% of claims get to payers with no errors upon the first submittal. The higher your holistic practice’s clean claim rate, the less time and energy your staff will waste on reviewing denied claims and re-submitting claims. A 95% clean claims rate or higher should be the ideal rate your practice should be aiming towards. 

Properly Submit Accurate Claims

One of the most important components of a successful holistic practice is submitting accurate claims the first time. By taking the extra time to review claims for any errors, your practice can avoid wasting time and energy from editing and resubmitting incorrect claims - and the weeks it takes for the delayed reimbursement to finally come through. And, since many holistic practices have a tighter bottom line than other medical practices, maintaining accuracy in your medical billing is essential for increasing revenue. 

Medical billing claims

Stay Up to Date on Medical Billing Rules and Regulations

Medical billing and coding regulations are constantly changing, and this is especially true about billing rules of holistic practices. Medicare is constantly updating its rules for what holistic procedures are covered, and staying informed can create a streamlined process that avoids delays and denies. Your holistic practice’s cash flow can be directly affected if you fail to stay in compliance with current medical billing rules. 

Consistently Look For Areas to Improve

Your holistic practice should always be looking for ways to improve. Consistently looking for ways to optimize your medical bolling can identify areas of performance that can help expand your practice. Besides keeping track of regulation changes with medical billing and in your specialty, manage your key performance indicators (KPIs) to monitor the accuracy of past performance to identify areas of improvement or success. 

Consider Outsourcing Your Medical Billing 

Balancing accurate medical billing and coding with growing your holistic practice can be stressful - and may make delivering care for your patients more difficult. Even if you follow these medical billing best practices, keeping track of changing compliance regulations and ensuring accurate billing may be too overwhelming for your internal team. So, what can you do? 

By outsourcing your medical billing to a trusted third party, time and energy is given back to your holistic practice so you can focus on what matters most - delivering care for your patients! Make sure you do your research and choose a medical billing company that specifically works with holistic providers so you can be confident your billing is being handled by experts

Trust Your Insurance Billing to the Holistic Billing Experts!

Leave behind in the past the stress of having to balance your holistic practice’s insurance enrollments, billing, and coding while delivering care to your patients! By choosing to outsource your insurance billing, your holistic practice can streamline your revenue cycle management and handle the responsibility of your medical billing - saving your practice both time and energy you can devote to more important matters such as growing your business and delivering care. 

As an experienced billing provider for holistic providers, Holistic Billing Services can help your holistic practice navigate the medical billing process to minimize denials and delays so you can increase revenue. With an expert partner by your side, you can focus more on treating patients to help your practice grow rather than worrying about insurance billing. To learn more about our billing services for holistic providers, talk to one of our billing and coding experts today.

April 29, 2021
 - by Antonio Arias, MBA, CHBME
Medical billing
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