Over 40% of U.S. physicians work in private practices. If you work in one of these practices, you may see a mix of in-network, out-of-network and private pay patients.
Payment processes can be complicated for people with out-of-network insurance, especially if they have to navigate reimbursement. Efficient medical billing practices make things easier for you, your patients and the insurance companies.
This article explores private practice billing tips and how you can implement them to get your patients reimbursed more quickly.
Why Faster Reimbursements Matter
Speeding up reimbursement increases your private practice’s efficiency and provides other benefits, including:
- Improves patient access to care: When reimbursement processes are unclear, patients are discouraged from seeking care. They may feel confused about what their responsibility as a patient is or unsure whether they can even afford care. When you help them navigate reimbursement quickly, you increase the number of patients who can access care.
- Enhances patient satisfaction: Patients’ first concern should always be their health. When you make payment an afterthought, you let them focus on their health. This adjustment can make them happier with their care and strengthen their relationship with your practice.
- Frees up your administrative staff: Complicated reimbursement processes often lead to your staff answering question after question to help clarify things. When you clarify and accelerate the process, you free up your staff to focus on your patients’ more pressing needs.
How to Accelerate Patient Reimbursements
Transforming reimbursement won’t just happen overnight. Your practice needs to take active steps to support its patients and ease its administrative burdens.
Here’s how you can do that in three steps:
1. Set Clear Expectations With Patients
Patients may face uncertainty if your practice doesn’t accept their insurance. It’s not always clear how payment and reimbursement will work out, either.
Your practice can provide clarity in these early stages by:
- Developing a financial onboarding process: Information is key. When new patients come in, provide a welcome packet that explains which insurance plans you accept as in-network and out-of-network, other fees, payment policies and how reimbursement works.
- Providing an insurance information sheet: This one-page document should give patients a basic understanding of insurance. It should cover what a superbill is, how they can use it and what to expect afterward. It should also cover the steps of the insurance reimbursement process. Explain terms like CPT codes and NPI.
- Encouraging patients to verify their benefits: Every patient has different insurance coverage. Some providers will reimburse out-of-network services at a reduced rate, while others may not reimburse at all. If they call their insurance provider, you can both learn what their insurance covers. Once they know their reimbursement rate and whether out-of-network costs contribute toward their deductible and out-of-pocket maximums, they can make decisions with confidence.
Together, these processes help your patients make more informed decisions. It empowers them to move more quickly and confidently.
2. Provide Accurate and Complete Documentation
Streamlining insurance claims includes your documentation process. When you provide quality documents to your out-of-network patients, you help them file for reimbursement with confidence.
Here’s how you can improve the quality of your documentation:
- Master the superbill: Ensure you fill out every superbill completely, including the patient’s ICD-10 code, the provider’s NPI number, the patient’s name and the date of services rendered. This attention to detail makes your superbills more reliable for both patients and their insurance providers.
- Establish a consistent delivery workflow: The superbill should not be an afterthought because it certainly isn’t for your patients. Standardizing your superbill production process can improve your efficiency and accuracy. In the long run, it saves patients and their insurance providers a lot of hassle. Many private practices allow patients to download superbills through a secure patient portal as soon as their payment is processed.
- Perform a quality check: The final stage of your workflow should be a thorough quality check. Before sending the superbill, a staff member should review it for errors. Common issues include typos in names, incorrect dates and missing provider information. Issues like these may seem minor, but they can be a considerable impediment to the reimbursement process. Catching them early saves your patients’ time and ensures they get the reimbursement they deserve.
3. Use Digital Tools to Streamline Claims
Reimbursement facilitates out-of-network care. The patient pays you for the care you provide and then gets reimbursed afterward by their insurance provider. This three-way relationship can get complicated because information has to be relayed between all three parties. If the information is unclear, it can lead to confusion, endless emails and even legal issues.
Luckily, Reimbursify simplifies this process and keeps everyone in the loop. This high-powered claim submission application makes it easy for your out-of-network patients to file reimbursement claims. All they have to do is take a picture of their superbill and submit it.
The app also:
- Positions your practice as a modern resource: Modern patients are looking for practices that offer a seamless experience. With Reimbursify, you can promote yourself as that practice. The app automates reimbursement claims so your patients can focus on what matters most — their health. For many, this medical billing assistance makes them far more likely to return to your practice.
- Offers claim tracking and support: The Reimbursify app provides real-time tracking and patient reimbursement support. Patients can check the app to learn their claim’s status anytime, anywhere. If their claim does get rejected, Reimbursify staff will help resolve the issue. You and your patients don’t have to worry about a thing.
- Improves customer satisfaction: For many patients, billing is the most stressful part of seeking medical care. When you automate that step, you ease that stress. You also give them room to make critical medical decisions. Many patients will leave your practice more satisfied as a result.
Empower Your Practice With Reimbursify
Reimbursify is a mobile-enabled software platform designed to empower you, your out-of-network patients and their insurance providers. Patients can file with us in as little as 10 seconds. They don’t have to worry about complex filing processes. You don’t have to troubleshoot issues between them and their insurance. It’s a win-win for everyone.
Learn more about Reimbursify, or schedule a demo today!
