Two Insurance Plans, One Claim: Where Secondary Billing Can Go Wrong
Two Insurance Plans, One Claim: Where Secondary Billing Can Go Wrong Having two health insurance plans may provide a patient with additional coverage. But for a healthcare practice, managing a claim involving more than one insurer can introduce questions that do not exist when only one payer is involved. Which insurance company is responsible for […]
How Do You Know If a Revenue Cycle Improvement Is Actually Working?
How Do You Know If a Revenue Cycle Improvement Is Actually Working? A healthcare practice introduces a new billing procedure. The team receives training, responsibilities are adjusted, and management begins reviewing the results. A few weeks later, employees report that the new process feels more organized. Claims are being reviewed more consistently, and certain tasks […]
What Payer Payment Patterns Can Reveal About Practice Revenue
What Payer Payment Patterns Can Reveal About Practice Revenue A healthcare practice reviews its monthly collections and sees that revenue is relatively stable. Payments are coming in. Claims are being processed. The overall numbers do not appear particularly concerning. But a closer look reveals something different. One insurance payer consistently takes longer to reimburse claims […]
When the Same Claim Denial Keeps Coming Back
When the Same Claim Denial Keeps Coming Back A claim is denied. The billing team reviews the explanation, makes a correction, and submits it again. The issue appears to be resolved. Then another claim receives the same denial. A few days later, the problem appears again, involving a different patient but the same payer or […]
What Patients Wish They Understood Before Receiving a Medical Bill
What Patients Wish They Understood Before Receiving a Medical Bill A patient visits a healthcare provider, presents their insurance card, pays the required copayment, and leaves believing the financial part of the appointment has been handled. Several weeks later, a medical bill arrives. The amount is higher than expected. The statement shows an insurance payment, […]
A Paid Claim Doesn’t Always Mean a Resolved Account
A Paid Claim Doesn’t Always Mean a Resolved Account A claim has been processed. The insurance company has issued payment. The billing system shows that money has been received. At first glance, that looks like a completed transaction. But a few weeks later, a patient calls about an unexpected balance. The billing team reviews the […]
From Daily Friction to Better Practice Performance
From Daily Friction to Better Practice Performance Most operational problems do not begin as major problems. They begin as small interruptions. A staff member cannot find the information they need. An account moves between people without enough context. A claim requires the same research more than once. A patient question takes longer to answer than […]
What Practice Leaders Should Be Able to See About Their Revenue Cycle
What Practice Leaders Should Be Able to See About Their Revenue Cycle Practice leaders do not need to know every detail of every account. But they do need to understand what is happening across the revenue cycle. How much AR is outstanding? Where are accounts getting delayed? Which payers are creating the most follow-up work? […]
The Connection Between Staff Efficiency and Financial Performance
The Connection Between Staff Efficiency and Financial Performance When a practice looks at financial performance, the conversation often focuses on collections, claims, denials, aging, and reimbursement. But there is another factor that can influence those results: How easily staff can actually do the work. If employees spend too much time searching for information, repeating tasks, […]
How Workflow Gaps Turn Into Revenue Delays
How Workflow Gaps Turn Into Revenue Delays Revenue delays do not always begin with a major billing problem. Sometimes they begin with a small gap. A task is handed off without enough context. A document is requested but nobody is clearly responsible for following up. A claim is waiting for information that another department already […]