By Jill Medzelewski
In a time when reimbursement seems to decrease while expenses increase, some medical practices are struggling to bring in revenue. Many are taking big steps, such as putting together joint ventures, merging with other practices, or investing in ancillary equipment. However, not every practice has the time and the means to take such complex and expensive measures. The good news is that there are other, simpler ways to quickly and efficiently bring revenue into your practice. Following are the three steps that I most often recommend when I visit practices experiencing cash flow issues:
1. Review your practice management system to verify all patients are receiving statements. Recently, I was in a practice that had a “programming glitch” in its practice management system that only allowed patients to be sent four statements–for life! If patients had been visiting the practice for several years and had already received a total of four statements, the system would not allow them to receive any more. There were countless co-pay and deductible balances for which patients were not getting billed.
Review your own system; check to ensure all your patients are receiving statements. If you are generating manual statements, stop! Most practice management systems will allow you to batch statements electronically, and will even mail them to the patients for you. This is almost always cheaper than doing it yourself.
2. Verify insurance. Merely glancing at a patient’s insurance card does not always verify their current insurance status. For example, a patient could present a card for an insurance carrier that they no longer have, and not even realize that they are giving you the wrong card.
Not too long ago, I was in a hospital-owned physician practice system completing an operational assessment. When asking the managers of the different clinics if they had instructed the front desk staff to verify patients’ insurance, one manager said, “No, I think that’s a waste of time.” However, the total dollar amount of charges denied for “no coverage in effect at the time of service” was well over $1 million–hardly a waste of time! That is not to say that the practice did not eventually receive payment, but those denied charges constituted $1 million in claims that had to be re-worked by someone in the billing office, costing the practice time and money. When the front desk staff verifies the insurance coverage (which can be done online for most payers), most denials are avoided. You may be skeptical that verifying insurance is really worth the time and effort, but in my experience, every practice that has implemented this simple task has seen denials reduced and cash flow increased. It really works!
3. Send electronic claims every day. With the ease of batching and sending electronic claims, there is no reason not to send them every day. Many practices, as a matter of policy, send them only once per week or several times per week. The sooner the practice delivers the claim to the payer, the sooner the practice receives payment. This allows the practice to send the balance to the secondary payer (if one exists) or send a statement to the patient, ultimately relieving the burden from the Accounts Receivable staff. Implementing this new insurance-checking system will reduce the bill’s days in A/R, putting your practice closer to the benchmark for your specialty, allowing you to focus on other issues.
Consider the processes in your practice and don’t be afraid to “think outside the box” to improve revenue collection. Too often we visit practices that follow established patterns because “that’s the way we’ve always done it.” Instead, look for opportunities to improve your processes to yield better results!
Jill Medzelewski works in The Coker Group’s practice management division as a consultant to medical practices in both operations and system management and solutions. She holds undergraduate and masters degrees in business administration from Georgia College and State University in Milledgeville, GA, where she majored in management. She was certified as a Professional Coder by the American Academy of Professional Coders in 2005.
For more information on increasing revenue and improving processes in your practice, contact firstname.lastname@example.org, or call 800.345.5829.