New challenges are brewing in today’s complex and ever-changing reimbursement environment. There are regulatory changes and increased patient payment responsibility due to high-deductible health plans. These challenges are just a couple of reasons that contribute to why 69% of physicians and practice owners nationwide cite cash flow and reimbursement as a top concern, according to a 2016 survey from Capital One Spark Business.
What seems like a formidable revenue cycle can result in a practice leaving money on the table and dragging down the financial health of your organization. Fortunately, there are 7 overlooked opportunities in the revenue cycle that, with a little attention, may help improve payment collection.
- Charge capture – Physicians need to not only understand what to code, but also what to document. Make sure you have a charge-reconciliation protocol which captures all services performed by your practice, and bills them appropriately. Create a closed-loop process to ensure charges are billed for every service.
- Work queue management – Make sure that you implement predetermined filing deadlines. Methodically and systematically prioritize your workflow. Sort work queues by filing deadline and dollar amount. Determine productivity expectations for staff working on patient accounts. Working 50 invoices per day is a recommended target.
- Denials – Understand why you are not getting paid. Identify the source of denials through reports and discussions with staff, and then fix the problem. Train staff about these issues and review top denials at every physician meeting. Don’t forget to recognize the contribution of every employee in the denial-management process.
- Payments – Not all payers pay correctly. Do you know what you are supposed be getting paid? Obtain the allowables for all services, then load current allowables for all payers and products. Review them at the line-item level. Take action.
- Hiring the right people – You want a minimal amount of people in your accounts receivable department. Hire energetic, make-it-happen, multitask-oriented people to work your accounts. Invest in these good employees…and consider re-assigning those who are less productive to areas of the practice that may align with their strengths.
- Patient collections – Today’s patient is also today’s new payer. Have a strategy for collecting payments from patients, whether by giving them a statement at checkout, or redesigning your collection process to twice-monthly billing. Consider migrating from your reliance on mailing statements – go electronic.
- Overhead – Overhead = costs divided by revenue. Most of your costs are fixed and are therefore difficult to cut. Your first reaction may be to cut personnel to reduce overhead, but know that personnel cuts may negatively impact your infrastructure, resulting in overhead costs going up. Understand the true return on investment (ROI) in your organization and apply it. You want to pay attention to costs, but put your energy into generating more revenue. Invest in your revenue cycle.
You can invest in your revenue cycle with a revenue cycle management (RCM) service. Quanum RCM provides a team of medical billing experts to take these complicated billing issues off your plate. A successful RCM service will reduce the amount of time from patient service to receipt of payment. To learn how we can help your practice with billing claims, denial management, and everything in between, phone us at 1.888.491.7900.
Learn more about how you can maximize these 7 commonly overlooked revenue cycle opportunities. Watch our recent webinar with industry expert Elizabeth Woodcock to find out how you can turn them into positive change for your practice.