How To Prevent Revenue Leakage in Medical Billing?

Every healthcare organization and firm faces the threat of financial leakage that can lead to a significant loss in profitability and revenue. The longer a patient’s medicinal account receivable (AR) remains unpaid, the fewer healthcare providers can recover reimbursement. In this aggressive market competition, a loss in revenue at medical billing can cost a significant upset. Companies can outsource the medical billing system to prevent revenue leakage.

According to a report, the global Medical Billing Outsourcing Market was at 11.1 billion USD in 2021. According to their projection, the market will rise by 17.1 percent compound annual growth rate (CAGR) from 2022 to 2032. If you are worried about revenue leakage, this article is for you. It will give you a comprehensive idea of some of the best practices you can follow to arrest revenue leakage in the medical billing system.

What Is Revenue Leakage?

Revenue leakage is a concern and condition wherein the provider renders a particular service to the customer but does not receive the payment. A “revenue leakage” situation can occur when outstanding billing and account receivable (AR) remains unpaid. Medical billing or coding systems often encounter this revenue leakage problem.

No single person or system is responsible for this revenue leakage. Revenue leaks can happen through gaps in the medical billing system, via healthcare providers, patients, billing departments, etc.

Measures And Best Practices to Prevent Revenue Leakage

As all healthcare services work hard to keep the lights on, here are some excellent ways to reduce revenue leakage.

  1. Proper Balance/Due Management Process

Collecting the patient’s balance requires an effective processing system with proper healthcare organization regulations. Healthcare’s in-house billing units must follow standard rules in medical billing. The organization must also provide seamless patient medical billing and management software. Catering to flexible payment systems like electronic payment methods and cash can eliminate revenue leakage.

  1. Avoid Denials related to Credentialing
    Whether a private practice or a large healthcare service provider, the organization must navigate and sketch out all the incoming requirements and regulations revolving around credentialing, privileging, and payer enrolment. Organizing all these operations is essential to run a profitable business and providing satisfactory patient service. Healthcare firms can also avoid such denials by outsourcing their medical billing services.
  2. Aware Of Unbilled Procedures

Individuals responsible for medical billing must remain aware of billable procedures and should not leave any minor procedures unrecorded. Healthcare organizations should educate physicians and medical billing individuals to reduce incidents of unbilled practices.

Such a practice can improve revenue in the long run. To eliminate unbilled procedures in your organization’s medical billing system, you can outsource the medical coding services and management service to a third-party provider.

  1. Avoid Underpayments

Keeping the right price for your service plays a significant role in generating stagnant or growing revenue. To stop revenue leakage while billing, you must avoid underpayments. Planning and revising the fee structure based on factors like maintenance, extra expense, inflation, market price, etc., can prevent underpayments. With proper analytics and monthly reports, healthcare firms can keep an appropriate service price and arrest revenue leakage.

  1. Patient Centricity
    All modern businesses are customer-centric, and so is your healthcare organization. In a healthcare firm, the patients are your customers. So, patient satisfaction should be the healthcare service’s primary responsibility. A proper billing system with appropriate billing software and management system can render customer satisfaction.

The research study suggests that in businesses, patients who register positive experiences from a healthcare service gain more faith in their providers. Hence, they don’t switch physicians and continue to leverage the care & services from the experienced provider. This trust of patients makes the medical billing on time. Hence customer-centric practices reduce revenue leakage.

  1. Proper Training Towards Billing

Billing problems and mishandling payments often cause inefficiencies in the medical billing management system. Such issues occur due to improper training of the in-house billing department and receptionist at the desk. Thus, healthcare organizations should train their billing personnel while keeping in mind handling patients with empathy and care.

Give charge of the billing process and management to certified and qualified personnel who can generate accurate billing and payment systems. Also, taking regular follow-ups of the due payment (from the patient by the medical billing personnel) is a good practice.

The Conclusion

Revenue leakage is a severe issue that healthcare providers often face when they do not receive payment or outstanding bills. Keeping your medical billing practice healthy and away from revenue leakage is essential to continue a profitable service. In the cut-throat competitive market, healthcare systems should focus on their healthcare service rather than medical coding and preventive revenue leakage.

Therefore, healthcare systems can outsource the medical coding service to a third-party billing provider. With this, the healthcare service can efficiently manage the core operations without glitches in the billing process and management.


I'm a CG Generalist, technical writer and crypto trader. I've completed my undergraduate degree in Software Engineering.

Related Articles

Leave a Reply

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

Back to top button