Over the past few months, I’ve posted some tips that I hope make it easier for you to correctly calculate a few key practice benchmarks (days in accounts receivable, net collections percentage , and accounts receivable greater than 90 days old ). There is one more benchmark, though, that I suspect is under-examined by many practices: the ratio of billing staff to providers.

It’s a difficult benchmark to discuss, because a practice’s size has a lot to do with it. A good ratio in a large practice is very different than one in a smaller practice—and understandably so. Larger practices not only achieve some economies of scale, but also tend to carve out employee responsibilities. While a large practice might have specified “coders,” “billers,” and maybe even a designated “Medicare specialist,” a smaller practice might rely on a single person to do it all in conjunction with other duties. Yet this ratio is still quite important.

In many practices, it’s viewed strictly as an “expense” indicator. However, I feel strongly that it’s also a significant overall gauge of your practice’s financial health. That’s because the lower your billing staff-to-provider ratio, the more consistent your revenue cycle tends to be. Read More ›

The new HIPAA electronic standard, 5010, update is something that will impact all healthcare entities, including physician practices, and as such, must be fully understood. The bottom line is this: if a practice’s HIT partners cannot handle 5010 transactions on January 1, 2012, its claims will be rejected by insurance carriers.

Join us on Tuesday, August 24 at 1:00 p.m. EDT, for a complimentary webinar: 5010 – Opportunity or Chaos?  Strategies to Survive the Transition. In under an hour, you’ll hear Ken Bradley, Vice President of Strategic Planning at Navicure, and Bryan Koch, Vice President of Strategic Services at Navicure, discuss what your practice needs to do in order to prepare for 5010, including:

• What 5010 is and who is affected
• The benefits of the new electronic standard
• Strategies to ensure a successful transition

Register now.

Not long ago I posted some strategies you can use to make sure you’re correctly calculating two of our industry’s most utilized benchmarks: days in accounts receivable (A/R) and net collections percentage. At the time, I briefly noted that it’s also important to check your A/R greater than 90 days old (A/R>90) because it’s possible for a good overall A/R number to mask problems with aging claims.

A/R>90 is a measure of a practice’s ability to get claims paid in a timely manner. This measure represents the amount of A/R older than 90 days as a percentage of the total A/R. Here’s how to calculate it: Take the dollar amount of the A/R that is greater than 90 days from the date of service, and divide that number by the dollar amount of your total A/R. Read More ›

The prospect of obtaining stimulus funding has, not surprisingly, created an environment of intense focus on Electronic Health Records (EHRs). While that’s OK, I see a distinct limitation in looking at EHRs, practice management systems (PMS) and other applications as isolated pieces of hardware/software. Instead, I think the current atmosphere provides many practices the opportunity to step into completely new systems, with a completely new way of viewing the components.

Rather than contemplating an EHR purchase or PMS evaluation in the context of “what’s available,” consider how well these technologies will serve as your platform from which to custom-build, taking into account future needs as well as current ones. Read More ›

Thank you to everyone who attended our June 23 webinar to learn how the national trend toward consumer-driven healthcare is changing the way providers do business.

During the one-hour event, Pamela L. Moore, PhD, Vice President, Content and Strategy, UBM Medica and Physicians Practice discussed:

• The importance of quality, pricing and patient satisfaction as it relates to consumer-driven healthcare.
• How consumer-driven healthcare impacts your bottom line.
• Strategies for providers to increase patient collections at the point of service

To learn more about the movement toward consumer-driven healthcare or to pass this webinar on to a colleague click here.

Every business office manager knows the challenge of trying to hold down the number of days in accounts receivable (A/R) and I’m no exception. As business office manager at Orthopaedic Specialists of the Carolinas, I’m charged with managing a claim volume of roughly 500-600 patients per day for 22 physicians, 10 physician assistants and 13 therapists.

I take pride in the fact that even with such a large claim volume—and four different locations—we average about 30 days in A/R. We’ve managed to accomplish this through a few distinct efforts.

First, we have become more proactive about collecting patient-pay balances prior to surgeries and other high-dollar services. With the difficult economic times, many patients have either lost their insurance or opted to increase their deductibles—which obviously has a direct impact on A/R. Read More ›

Using benchmarks to rate the success of your practice’s revenue cycle is an age-old “best practice.” No matter the specialty or size of your practice, it is important to periodically track, trend, and review performance data. It is the only surefire way to understand your financial strengths and weaknesses, and subsequently improve both.

One of the biggest challenges I’ve found, however, is that practices may think they’re adequately tracking certain benchmarks when they’re not. In reality, it’s not at all unusual for practices to be a little uncertain about whether they’re correctly calculating and analyzing important numbers.

So, I’d like to address two standard benchmarks that, in my experience, are particularly thorny: days in accounts receivable (A/R) and net collections percentage. It’s essential to track both accurately, because they demonstrate a practice’s ability to quickly turn over A/R and collect all money due. Let’s walk through: the definition of each term; the proper way to calculate each; an example calculation; and some common potential analysis pitfalls. Read More ›

Managing your revenue cycle is a daily need. Typically, a practice’s primary focus is on claim submission and denial management. While I agree that these two aspects are extrememly important, there is another aspect to revenue cycle management (RCM) that you may be overlooking, and it’s rapidly gaining in significance: eligibility verification.

Eligibility verification is one of those things many practices used to do once a year, when patients presenting for appointments would be asked to “update their files” by validating or filling out new insurance data forms. More recently, practices have adopted the procedure of periodically asking, “Is your insurance information still the same?” Read More ›

Join us on Wednesday, June 23 at 1 p.m. EDT for a complimentary webinar
to learn how the national trend toward consumer-driven healthcare is changing the way providers do business.

In under an hour, you’ll hear Pamela L. Moore, PhD, Vice President, Content and Strategy, UBM Medica and Physicians Practice discuss:

• The importance of quality, pricing and patient satisfaction as it relates to consumer-driven healthcare.
• How consumer-driven healthcare impacts your bottom line.
• Strategies for providers to increase patient collections at the point of service

Register now.

Running and working aging reports is a task that tends to be put on the back burner in many busy practices, but neglecting it can negatively affect the bottom line. When rejected claims get out of control and accumulate, two things can happen: 1) revenue can slow, and 2) you risk hitting timely filing limits (which could mean no payment at all for some of your claims).

Fortunately, there’s no reason to let the task become overwhelming—just make sure that your practice proactively tackles rejections by understanding how to run aging reports in your practice management system. This will allow you to run and work aging reports on a regular basis. A good rule to follow is that these reports should be run at least every 30, 60 or 90 days. By doing this, you can quickly see which claims remain outstanding, so you can take action to make sure they get paid. Read More ›