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MediGain Blog

The switch from the traditional model of fee-for-service (FFS) reimbursement to value-based reimbursement is arguably one of the largest and most significant policy changes going on within our country--and it's only just getting started.  Many unknowns exist, which can be unnerving for providers. For instance, nobody knows exactly how long the transition will take, and its impact on our healthcare system, particularly during the interim period (which could take years), has yet to be seen. Additionally, since Medicare expenditures and the expansion of Medicaid have been on the rise to accommodate for our aging baby boomers, the system as it is already has put put a significant strain on facilities' revenues, since Medicare/Medicaid patients are generally not profitable.

It is in the best interest of both the patient and the doctor's office that claims processing occurs in a timely manner. There is no better way to scare away patients than to subject them to multiple billing calls because their insurance claims are not paying their doctor. From a business standpoint, it is important to make sure that claims are processing on schedule in order to keep the revenue stream steady. One of the best strategies for keeping the claims process simple and sufficient is making sure that each member of staff is doing their part. Here are the top 5 in office touch points to ensure that claims processing occurs in a timely manner.