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How to Improve the Medical Billing Process?


Streamlining your medical billing procedures could help transform patient care and administrative operations in the healthcare industry. Here's what you need to know - we've identified six key strategies for ensuring a successful, efficient billing process that can maximize effectiveness throughout your organization.

1. Maintain and Update Patient Files


To handle claims billing, you need to have precise details on your patients. During each visit, your team should confirm that patient information hasn’t changed since their last visit. Essential elements like a change of address or changes to insurance should be noted. Managing patient details is crucial to ensure it matches up with third-party payers’ records.

2. Automate Your Billing Functions


Automating the billing functions of your medical practice can make the billing process easier, faster, and less prone to error. By introducing automation into the system, you can eliminate administrative tasks associated with submitting claims, tracking payments, and handling patient inquiries. Automating these processes saves time for staff and helps maximize both accuracy and efficiency in coding, revenue cycle management, and invoice creation. Automation also allows for real-time monitoring of account receivables. Patients benefit through faster communications about their bills as well as more accurate information regarding deductibles or outstanding balances. Ultimately, automating the billing process saves time and money while helping to ensure accuracy and improved patient care.

3. Track Denials


Tracking denied claims could be used as a learning opportunity to improve your process.

There are three common reasons for denials:

• Specialists are not properly credentialed.

• A lack of sufficient documentation.

• The use of codes for services and equipment that are not covered by carriers.

Keeping track of chart notes and denial codes daily can reduce the risk of denials. However, if you are still seeing a high rate of denials, it might be time to update your coding protocols and verify your patient’s coverage.

4. Outsource Problematic Collections


Working with a professional team of experts can help to dramatically improve the medical billing process. Outsourcing problematic collections to billing companies such as Shoreline brings specialized knowledge and performance-based solutions to ensure fast, accurate collection of payments. With their reliable systems and highly trained staff, Shoreline is able to employ innovative techniques to drive the resolution of accounts and reduce turnover time on denials. By streamlining the overall process, healthcare providers can better manage their business, while concentrating their efforts on other essential areas such as patient care and satisfaction.

5. Enhance Quality Control


Enhancing quality control in medical billing is essential to maintain accuracy and minimize mistakes. Quality control can involve regularly checking invoice accuracy, verifying patient data when entering new information, and scanning payments for discrepancies. Systematic use of quality assurance protocols can help detect errors early in the process, giving healthcare providers an opportunity to proactively address mistakes and prevent costly payment delays. With comprehensive quality control standards in place, medical billers can streamline processes and better adhere to regulations to ensure invoices are correct and payments are received in a more timely manner.

6. Follow Up on Claims


Following up on claims can make a significant difference in a medical practice’s revenue. Staying proactive by actively monitoring claims status can improve communication between payers, providers, and patients, thus increasing revenue and preserving relationships with insurers. Ultimately, following up on each claim helps to ensure the accuracy of records and limit unnecessary paperwork associated with the medical billing cycle.


It's clear that streamlining your medical billing procedures can have a profound impact on both patient care and administrative operations within your office. By following our six key strategies — maintaining and updating patient files, automating functions, tracking denials, outsourcing collections, enhancing quality control, and following up on claims — you can ensure an efficient and successful billing process. We hope you now feel properly equipped with the knowledge to take the necessary steps in optimizing your medical billing processes. At the end of the day, creating an efficient billing process is invaluable when it comes to the success of your practice.

Don’t wait any longer, contact Shoreline Medical Billing today!