Revenue Cycle Management: Fee Scheduling (Part 6)

Fee schedules are the most subjective things in all of healthcare and can swing wildly from provider to provider, as well as facility to facility. It’s also one of the most mystical things for patients to understand. In fact, it’s is one of the most frequent patient questions we get as a medical billing service company.

(At MEREM Healthcare Solutions, you can get custom reports for your medical practice. These allow you to really understand what is happening to your revenue cycle, and how you can change it to increase your profits.)

Why Are Fee Schedules Important?

Fee schedules are a full list of fees for procedures that insurance companies use to determine reimbursements for physicians. They help the office staff determine coinsurance rates and patient deductibles, and they are the basis for how much a physician can make for a procedure.

As a medical billing service company, we frequently see practices that have overlooked fee schedules for far too long. Most of the time, the result is a significant loss in revenue, but sometimes the consequences are even worse. Failure to stay on top of fee schedules could result in a loss of patients, an audit, penalties, and/or a massive back up from delayed claims. There is simply no denying the importance of fee schedules on a practice’s’ revenue cycle.

How Do You Utilize Fee Schedules? Analyze Them

Insurance companies change their fee schedules continually. Some update them annually, others quarterly. It all depends. That is why consistent oversight of your payers’ contracts will guarantee you don’t miss any changes.

One way to analyze your fee scheduling is to compose a list of your top procedures and their codes. Compare these codes to the insurances’ allowable to make sure you are charging your patients correctly, and billing for what you deserve. Some payer contracts offer tricky language that might make a physician charge less.

Always check to make sure your office has updated their coinsurance and deductible rates. If deductibles have gone up, and your practice is still charging less, chances are they will be billing less, too. A smaller bill means you aren’t asking for the money you deserve.

Insurance companies bank on these types of physician mistakes to make more money, and it works. Imagine a physician is charging just two dollars less than the deductible rate on a common service. If that service is completed 6,000 times a year, the total revenue loss is $12,000. With that in mind, continual analysis of your fee schedules could really help rake in the cash, cash that could be used for employee bonuses, updated equipment, and much more.

Hire A Medical Billing Service Company

Fee scheduling is extraordinarily important for revenue cycle management, and it’s difficult to stay up to date. Hiring a medical billing service company will alleviate your office staff of those duties. With a professional company handling your revenue cycle management, you are likely to see a boost in your revenue, a positive shift in compliance rates, and more accurate billing all around.

Hand over your medical revenue cycle management to professionals who care about your success, and more importantly, your patients’ health care. It’s time to focus on what’s important.

Are you ready to get help? Contact us today.