Rehab Billing: Best Practices for Healthcare Providers

Running a rehabilitation center entails a great deal of administrative tasks. On top of that, DIY billing can be onerous, especially if physicians are trying to monitor billing while also treating patients. When there are always unresolved questions, it becomes tremendously stressful for medical professionals to try to provide their complete attention to patients.

Billing for rehab isn't overly complicated when compared to many other disciplines of medicine. However, several practitioners may be involved in each patient's care; some will be in-network for each carrier, while others will not. Therefore, you can opt for best practices of rehab billing and coding to enhance and maximize the reimbursements:

• Respond to Information Requests for Rehab Billing

The number of audits, whether by CMS or commercial payers, is increasing. While you may be able to avoid it for a while, the truth is that you will ultimately receive that dreaded letter from your auditor. Instead of worrying, you can take steps to make the procedure as easy and efficient as possible.

When faced with an audit, the best thing providers can do is respond to information requests promptly and follow payer instructions. In the case of CMS audits, providers typically have 45 days to answer requests for more information—which means you should get on top of those requests as soon as possible. Clinics may consider assigning a mail sorter and having that sorter prioritize any mail from payers so that it is opened as soon as possible.

• Have Claims Denial Process

Claims denials can be hectic and time-consuming for your rehab medical billing department and a drain on your clinic's cash flow. As a result, developing a procedure for how your clinic handles claim denials can lessen the possible impact on the efficiency of your personnel and your finances.

Ideally, you should choose who will evaluate the denial and thoroughly read the accompanying notification, explaining why the claim was denied and how it can be amended and resubmitted.

While it is possible that you can modify and resubmit claims denied due to missing data and paperwork, denials for eligibility, authorization, or non-covered services are unlikely to be appealable or correctable—yet far too many clinics waste time trying to appeal.

• Follow up on A/R

Handling the accounts receivable is difficult, which is why many clinics put it off until the end of the month, if not longer. However, A/R is another example of crucial revenue that is being held up in your clinic. There is still something you can do about it.

Each month, provide time for professionals to concentrate on collections and follow up with patients on outstanding accounts. While you can use a collections agency, you risk damaging patient relationships with harsh tactics, not to mention the reduced financial returns and the expense of leveraging an agency. To mitigate possible collections, ensure patients understand your payment policy from the start and have your front office staff members collect outstanding balances while scheduling customers for their next appointment.

• Check on Returned Mails

Along the same lines as collections, ensure that your billing department follows up on any patient statements that arrive as returned mail. Time spent searching down delinquent patients may not be what your billing staff expected, but it is critical for increasing revenue. It may appear like collecting on those accounts will take a significant amount of time and money, but there are affordable skip tracing systems available that cost $20 to $60 per month and can help you locate patients. Alternatively, a few free or low-cost skip-tracing tools are available if you have some time and inventiveness.

In an era of limited clinic resources, your clinic must collect every dollar owed to reach revenue targets. This means your rehabilitation billing team must maximize what you collect and how you collect it.

Outsource your Rehab Billing Practices!

Changing federal rules, out-of-pocket expenses, pre-approval and referrals, limited number of visits, and service duration are all elements that require special consideration in the rehab medicine medical billing process. Outsourcing to 24/7 Medical Billing Services for quality rehab medicine billing services is the need of an hour to enhance the revenue. Our extensive industry knowledge enables correct claim submission for maximum reimbursement. We can address the issues resulting from ambiguity in coverage policies and use our professional skills and modern web-based technologies to process your claims as quickly as possible.

See also: A Step-By-Step Guide For Substance Use Dis-Order (SUD) Billing