1. Health

Everything About Sleep Study Billing Quality Assurance

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Effective sleep study billing and coding is paramount for revenue cycle management in sleep study practices. In its most simplified form, the revenue cycle in medical billing consists of various steps from effective patient documentation to payment posting.  

Clearly, in such an elaborate process there are many opportunities for something going wrong which will eventually result in revenue loss. To minimize the claim denial rate and enhance patient satisfaction, you must ensure the quality of your billing and coding services in sleep study. 

How to Maintain Quality in Sleep Study Billing 

When it comes to improving revenue cycle through effective sleep study billing, there are some checkpoints you should be aware of. Check out the following list of quality management to improve operations in your practice. 

  1. Insurance eligibility: The primary step of quality assurance is patient insurance eligibility. Check the proper details of insurance coverage to ensure an effective billing service.
  2. Auditing codes: Codes in sleep study are quite intricate considering the implementation of ICD-10, CPT and HCPCS level II codes. You need to maintain a regular audit for errorless coding within the RCM process.
  3. Track AR days: You must be aware of the AR buckets of your practice. Always monitor the AR days and maintain a constant follow-up.
  4. Determine your net collection: Net collection ratio refers to the amount you are paid divided by your total charges minus adjustments for a given period. This lets you understand how much of your allowed charges you received for the rendered services.

The Bottom Line 

Most sleep study practices are leaving money on the table, thanks to inefficient sleep study billing. The disruption within the RCM is leading the practices towards detrimental financial health and thus deteriorated quality of services. Maintaining quality at each step of RCM is extremely complex due to the intricacies in medical billing and coding process. Furthermore, the existing clinical responsibilities of your staff make it more difficult for them to accomplish administrative tasks.  

A professional RCM partner can increase your claims recovery from 15-20%. One of the biggest advantages of outsourcing an RCM company is reduced stress and improved quality of billing and coding services. It further increased the job satisfaction of your existing staff by reducing the administrative burden on them.  

Additionally, a team of expert medical billers and coders have knowledge regarding the coding and billing requirements. With the implementation of comprehensive technology and an informed decision-making process they can ensure the quality of your services.  

When it comes to elevating the financial health of your sleep study practice while maintaining patient-centered care, a proactive and holistic approach is necessary. To maintain an end-to-end approach in your practice you can always consider a genuine RCM partner who can drive your ROI.