Too often, medical practice managers look at cutting costs
rather than increasing revenue. Successful practice managers and administrators
know that maximizing revenue is No. 1 for financial strength.
"Depending on the compensation structure of the
physicians, a substantial net income may be expected in order to pay bonuses.
For others, simply keeping a positive number to support the current salaries is
acceptable. Either way, it is important to manage the bottom line of medical
practice to verify financial expectations of the owners are being met,"
explains Dixon Davis, VP of practice management for AAPC, a company that trains
and provides credentials in documentation and coding audits, regulatory
compliance and physician practice management.
According to Davis, there are six fundamental steps to achieve
financial success in running a medical practice today.
1. Maintain productivity. One of the most important elements
of achieving financial success in a clinic is having productive providers.
After all, higher productivity results in higher revenue. Effectively
monitoring productivity helps manage the provider’s expectation of how it
affects compensation and the bottom line. In addition, a manager should always
be looking for ways to enhance revenue streams through creating more efficient
processes and additional services.
2. Capture all charges. Once services are provided it's
important that all of the charges are captured, Davis said. First, make sure
every service that's performed is identified on the billing sheet or in the
EHR. This means that any providers, nurses, technicians or other staff involved
in providing services must properly document everything they do. Second,
accurate documentation and coding of the services being performed is vital.
Medical claims are paid based on procedure and diagnosis codes so they must be
accurate to ensure revenue is not left on the table or is put at risk or
recoupment. Third, submitting this information in a timely matter is important.
3. Verify clean information is being sent the first time.
Correct insurance information, demographics and code entry is imperative for
the initial submission. Incorrect information results in denials and delayed
payments, which can directly impact revenue streams and increase costs. Review
all processes involved with collecting this information and make it a priority
to get it right the first time. This is effectively done with clearly stated
processes and expectations followed up with periodic audits to identify areas
of improvement.
4. Effective office collections. Being disciplined at
collecting patient balances due while the patient is in the office is key.
While it's an easy concept in theory, it is still not carried out well by many
health providers. Co-pays, deductibles, co-insurance or past due balances are
much easier to collect when the patient is in the clinic versus weeks, or
months, after their visit. This requires a clear policy on what's expected,
training for the office staff on how to be effective and a culture where patients
are held accountable.
5. Effective collection policies and procedures. The
effective work of a billing office is vital for collecting all of the money a
practice is entitled to. Billing departments need to have clearly stated
collection policies/processes. This includes how to work denials, following up
on aging claims, how and when to collect from patients, when to send claims to
collections and when to write off bad debt. Spend time identifying processes
that are as simple and straight forward as possible, and then provide good
education and training so that the staff knows how to be effective in their
responsibilities. A billing office staff is much more effective when working
within a structured process than making it up as they go or taking the path of
least resistance. A manager should have set metrics that are measured and
reviewed with the staff on a regular basis to maintain direction and identify
areas needing correction.
6. Regular review of contracted payer rates and operational
costs. Healthcare providers should review contracted payer rates periodically.
This ensures they are negotiating the best rates available so they may maximize
revenue opportunities. Also, it's important to maintain cost structures. After
establishing a strong revenue flow, reviewing costs such as liability
insurance, supplies, phone contracts and other operational expenses helps make
certain you are receiving the best prices available.
Source: healthcarefinancenews
No comments:
Post a Comment