3 reasons why your Practice is not in Profit

Did you know, incorrect coding, missed submission of charges, under-pricing and lack of follow-ups are some of the reasons why approximately 25-30% of all medical practice income is lost? It is very important for physicians to ensure that they are able to care for patients without the fear of losing money.


If you are also struggling with loss of income, then here are top three reasons why it might be happening:


  1. There are chances you are losing money due to missed charges. If billing receivables are not coded to the correct levels, a large amount of money will be lost. You cannot mess with coding and clinical documentation. This can be prevented only when you have well-trained staff who can avoid making errors involving missed charges. Your practice needs to have a friendly environment where staff from billing department, data entry and coding department can communicate with physicians about reported codes and charges.


  1. Second reason why your practice may be losing money is bad billing practices. Make sure your billers are competent and well-trained. Incompetencies on part of your staff can also cause trouble. For instance, if the staff at the reception fails to update the patient insurance coverage, claims might be sent late or to the wrong place. This will again result in loss of revenue. Therefore, in order to prevent this from happening, you will have to hire a team of experienced billers and coders who are familiar with proper billing practices.


  1. Third common reason behind revenue loss is down-coding. If your coders are deliberately selecting billing codes that are lower than the services you actually rendered, then it can turn into an expensive problem. According to a study published in Medical Economics, a single doctor can experience $40,000 in lost revenue every year due to down-coding. A very common reason for down-coding is that the physicians don’t have a clear understanding of how to bill E/M services. In case of an uncertainty, they tend to under-code. If you are also doing the same, then you must start billing at the appropriate level and back up the coding with thorough documentation.


If your practice is still losing money, then hidden inefficiencies could also be the reason. This is why it is recommended to let a reputed medical billing company handle the revenue cycle needs of your practice.

Leave a Reply

Your email address will not be published. Required fields are marked *