Medical Billing Tune Up & the Nine Step 1st Medical Billing® Check List

Indicators that suggest problems with your billing include:

  • A growing AR balance;

  • Claim data is not entered daily;

  • Patient statements not sent regularly;

  • Payment posting in error.

In some cases, approximately one fourth of all medical practice income is lost due to: lack of follow-up; missed charges; or a consistent approach to billing medical claims. Is your practice among those receiving seventy-five percent of available billing revenue?


Here are nine ways to improve medical billing and maintaining financial health.

1) Patient Verification medical_billing_verify_patient_eligibility

  • Verify patient eligibility BEFORE filing a claim.
  • Verify patient eligibility to avoid surprises and ensure claim payment.
  • Check to see if a prior authorization or referral is required.

2) Collecting Copays, Coinsurance and Deductibles medical billing collect copays

  • The best time to collect is before services are rendered.
  • Use payment systems with patient credit cards on file for installment balance billing.
  • Use on line payment estimators for coinsurance and deductibles .

3) Correct Claim Coding medical billing coding

  • Poorly coded claims pay poorly.
  • Use correct modifiers to ensure payment for bilateral procedures or multiple procedures.
  • Patient’s seen during the global period may need additional modifiers.

4) Daily Claim Entry medical billing daily claim entry

  • Cash flow is vital. Enter claims daily for prompt payment.  It is really that simple.
  • When claim entry is delayed, billing is delayed.
  • Additional time is required to research billing information the later the claims are entered.
  • The details about missing demographics or other claim data will not be fresher in a few days.

5) Daily Claim Filing medical billing send claims

  • Claims entered need to be transmitted daily.
  • The sooner claims are received by insurance companies; the sooner they will be paid.
  • Clearinghouse claim rejections need to be resolved the same day they are received.

6) Daily Claim Denial Management  medical billing no denied claim

  • Some claims are denied by insurance shortly after filing.
  • The issues vary and can be simple coding fixes, or patient eligibility issues.
  • A denied claim is an unpaid claim.

7) Daily Payment Posting medical billing payment posting

  • Maintaining accurate billing data requires real time information.
  • Many claims will require billing secondary insurance claims or patient billing.
  • Patient billing can represent 10-20% of account receivables and until the primary payment is posted no additional balance billing can be sent.

8) Daily or Weekly Patient Billing medical billing patient billing

  • Practice management software system that support daily or weekly patient billing is a must.
  • Billing all patients on the same day once a month is too infrequent. If all patient bills are sent today, a patient seen a week ago would not be billed for another four weeks.
  • The sooner patient bills are sent the more likely they will be paid.
  • Statements need to be prompt and accurate. If a patient doubts the accuracy of a statement it can delay payment.

medical billing AR

9) Review Accounts Receivables (AR) Daily

  • Yes daily. You can’t get paid if you don’t ask for your money.
  • Not all claims will require action but having a system in place for frequent follow up on unpaid claims is key.
  • The three keys to financial health of your business . . .AR, AR, AR!
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