Have you noticed your Medicare reimbursements have decreased or delayed?

Do you have a large amount of Medicare patients? Have you noticed your Medicare reimbursements have decreased or delayed? Are you seeing a large amount of Medicare denials and adjustments with no reimbursement for your services?

It is a very high possibility that you are correct when believing your Medicare reimbursement is lower than it should be. Medicare offers a wide range of plans and the majority of those are not the traditional red, white and blue Medicare. As an outsourced medical billing, coding and consulting company, MEREM Healthcare Solutions is seeing an increase in denials and loss of revenue for our clients due to this particular issue.

Areas most affected:

• Delayed or loss of revenue
• Authorizations, Pre-certifications, and Referrals
• Copays, deductibles and time of service money are not being collected
• Eligibility is inaccurate
• Increase in denials
• Improper billing
• Inaccurate records within the practice management system

What exactly is happening here and who is to blame?

Is the patient responsible? Is Medicare responsible?

What about your staff or your outsourced billing company?

Without proper training of your staff and/or outsourced billing company, your practice could be losing money. This is affecting the majority of providers, surgery centers, diagnostic centers, and much more across the United States. Simply put, time is money. Reimbursements that typically take weeks, end up taking months if you are lucky because multiple employees have to work an account’s error due to lack of training.

Another significant revenue loss in reimbursement revenue occurs when services are not being pre-authorized and a majority of payers will not allow you to obtain an authorization after services have been rendered.

This Medicare reimbursement and revenue loss is a trickle-down effect that starts with the patient and ends with payment posting, but almost always depends on the accuracy of your staff’s benefit verification and up-front collections practices.

MEREM Healthcare Solutions can help.

We know exactly what each of your staff should look for in this case. Your front desk and scheduling must be able to catch this prior to services being rendered so that providers can feel secure in being reimbursed for their services. This will bring you a much faster reimbursement, fewer write-offs and an increase in revenue.

Whether you need to improve your front office processes, improve clinic output, or need further coaching on your encounter documentation, this is where the MEREM Healthcare Solutions consulting team comes in to help your staff (and your practice) reach their maximum potential. We offer both on-site and remote training, so there is a solution to fit any size staff and any size budget. With Merem Healthcare Solutions on your side, we will help you identify areas of improvement and help you hold your staff accountable. This is just one of the ways MEREM goes above-and-beyond to act as your strategic partner towards our mutual goal of improving your revenue.

Contact MEREM Healthcare Solutions Today at (205) 329-7519 if you are observing significant reimbursement loss and would like to discuss your revenue improvement.