Efficiency is the cornerstone of any healthcare setting. Thus, a smooth-running medical claims process is critical to the success of any medical practice. It affects not just a practice’s processes and productivity, but its revenue cycle as well. 

Although there are challenges that can arise during the claims process, such as denied claims and complex procedures, there are a number of solutions to help speed up the process and increase the accuracy of medical billing and claims management. 

Here are 6 strategies that can be implemented to improve any practice’s medical billing and claims process: 


  1. Accurate and Complete Patient Information
  2. Hire a Billing Expert
  3. Automate and Digitalise
  4. Implement Training Sessions
  5. Diligently Follow Up With Claims
  6. Record Keeping


It all starts with the patient. Getting accurate and complete information from all patients is the first crucial step. This strategy already avoids a lot of simple, yet frequent, mistakes along the way. 

Ensure that staff are trained to check and validate demographic- and medical aid information with each and every visit (this applies to new and existing patients). 

Why do this?

  • Patients can change their medical aid details, for example, changing to a different provider.
  • Patients may opt to become dependants on their spouses’ medical aids.
  • Patients can also move from one location or job to another.

Always double-check patients’ information and ensure that the information matches the records of third-party payers.


Invest in your practice by hiring a billing expert who can assist with monetising overlooked income opportunities. Choose a billing expert with advanced knowledge and experience of the practice’s speciality billing codes and rules to ensure accurate and optimal billing.

By hiring a dedicated billing expert, one can be rest assured that all billing and medical claims can be switched/sent out daily to ensure correct figures and a healthy cash flow.

As a result, billing experts can solve various issues that may arise during the medical billing and claims process. Billing experts are medical billing professionals that know what medical codes to use and will provide quick, accurate and efficient billing and claims services.

Now a healthcare professional can devote all their energy to providing quality care to their patients.


In this day and age, using staff to do tasks that can be automated will be a drag on any medical practice. Opt for an automatic and digital approach that allows healthcare professionals and their staff to focus more on patient-centric and personalised care services.

How exactly can one do this? Invest in medical software that not only fits a practice’s requirements but one that offers automated functionalities. A great start is identifying billing and claiming tasks that frequently occur in one’s practice that have become a mind-numbingly repetitive routine.

Examples of automated and digital systems can include the following: 

  • Updating patient information through an integrated patient portal.
  • Paperless filing – have all patient information, clinical documents, communication, claims and accounts, for example, in one place. 
  • Setting up billing macros/combinations that consist of a set of medical codes that are always used for each specific treatment. 
  • Create multiple invoices simultaneously and send the batch to be claimed by their respective medical aids with one click. 
  • Sending mass communication to patients regarding their outstanding accounts with a click of a button. 

By utilising technology, discrepancies due to poor penmanship or misplaced files can be avoided. 


Dealing with medical aids is no easy job. Each medical aid comes with its own set of rules and regulations when it comes to billing and claims. Implementing training sessions for staff can be a wise move. Training that centres around billing and claims processing will have a ripple effect on each role in the practice. 

For example, if the receptionist understands the importance of accurate and complete patient information, they will understand that it plays a key role in the billing and claim processes which may eliminate the risk of rejected claims due to inaccurate/incomplete patient information. 

Training will, therefore, ensure that each role in a medical practice has the information necessary to expedite claims processing. 


Having a strict follow-up procedure in place is the cornerstone of good cash flow. When claims are denied due to error, your income will be delayed. The billing department should regularly be in contact with medical aids and patients to conduct follow-ups to keep track of all claims. 

It is important to ensure that all claims are checked daily for the following reasons:

  • Maintain a steady and healthy cash flow.
  • Reduce the amount of time that accounts remain outstanding.
  • Ensure that all claims are submitted to the medical aids before they become stale.
  • Reverse, redo and resubmit erroneous claims in a timely manner.
  • Move any outstanding or rejected claims to the patient liable portion of the account so that patients get notified to pay any outstanding amounts.

After claims have been approved by medical aids, the billing expert still needs to make sure that these claims are actually paid and accurate receipts are processed. Electronic remittance advices (ERAs) save a lot of time and prevent erroneous linking of receipts to invoices. All payments must be correctly allocated to invoices so that reporting can indicate which unpaid claims need to be followed up.


Record keeping is an important part of accounting best practices and keeping an updated log of each patient’s bills, claims and receipts can be managed in software. Logs will assist bookkeepers and auditors to verify financial records.

Logs should include the following information:

  • The patient’s full name. 
  • The patient’s account number at the medical practice. 
  • The receipt number.
  • Date of service and/or referral reference number.


An electronic medical billing system is, therefore, of paramount importance to achieve an efficient, patient-centred and financially stable medical practice. Implementing the strategies as discussed will be well worth the effort and investment.