Biggest Problems in Medical Billing

Medical institutions all over are facing a serious problem when it comes to billing. In just about every healthcare system, there are issues surrounding the issuance, follow-up and payment of bills. Some of the problems are with patients, others with the medical establishments themselves. In any event, what they all really need are modern, effective and innovative medical billing and payment solutions.

What exactly are these problems in the world of medical billing? Let’s see some examples below:

1. Lost Revenue

We should start with the big worldwide issue first that is most in need of innovative solutions, and that is the amount of money that is lost by billing errors. The WHO has already called this problem “the last great unreduced health-care cost.” Billing errors apparently waste an amount equivalent to 7 percent of global health expenditure — US$ 487 billion.

One Australian study from 2018 showed that just educating people more about medical billing was able to save AUD 250 million in a single year from waste of AUD 1 billion in total. With so much money being lost to billing errors, smarter solutions that can remove human error as much as possible from the equation are the answer.

2. Late Payments

When systems rely on either patients to pay for services or insurance companies to come forward and pay for things, then delays in payment appear to be inevitable. Solutions focused on widening payment accessibility such as opening up online payments, credit card payments and other channels can help, but implementation proves tough for some.

3. Staying Up to Date with Patient Information

Verifying people’s personal and insurance information is an inseparable part of the billing process, and when the current software solutions are inadequate and information gets out of date, then many more steps have to be added to the process in order to get the right information and then confirm it before the original goal of getting payment for something can be completed.

4. Incompatible Medical Coding Systems

Some software solutions have proven unsuitable for the Australian market because of the differences in medical coding. With some systems being geared towards the US standard in medical coding, they remain woefully incompatible with the system used in Australia, namely ICD-10-AM, ACHI, ACS — International Classification of Diseases 10th edition Australian Modification, Australian Classification of Health Interventions, Australian Coding Standards.

That’s quite a mouthful, we know, but it’s absolutely crucial in the seamless sharing and understanding of information. When the digital system doesn’t understand the standard coding, then there is a serious communications breakdown.

5. Quality Control – Dealing with Errors and Complaints

A smart billing solution will actively help to eliminate errors across the system. What’s more, if and when errors do occur, accurate and complete information is needed within a log that records the patient’s name, account number, cash reimbursement amount, etc.

These logs form a trail that allows healthcare providers to keep full track of all cash flow and revenue payments. This is an indispensable tool in the war on medical bill waste that already costs the world billions of dollars.

6. Assistance with Tech Implementation

Finally, one other big problem is that when high-tech solutions are employed by medical establishments, they frequently don’t include enough support in implementation, which leads to further problems. Establishments and their teams need sufficient training and tech support right up to the point where a matured and experienced in-house team is in a position to take over that role.

In short, the medical world is in sore need of real and innovative billing solutions. With so much still slipping through the cracks, no one can afford to wait any longer.