Thank you to everyone who attended our September 30 webinar, Protecting Your Revenue: Proven Approaches to Enhance Your Bottom Line. In this one hour event, Bette Warn, Executive Director at ATD Resources, discussed the strategy that her organization used to  help them realize revenue cycle improvements, including improving payment per case by 17% in less than one year.

During the event, Warn explored what this strategy entailed and how it can help all healthcare organizations focus on revenue cycle improvements that will enhance reimbursement. In addition, she provided:

• Practical, hands-on approaches for improving the bottom line.
• Strategies for identifying opportunities for change and improvement, as well as effective tactics for implementation.
• Tips and techniques for exploring and selecting technology and tools that will most effectively help organizations achieve their medical group objectives.

To learn more about this revenue cycle management strategy, click here to download the recorded webinar.

Ask practices why they use a clearinghouse solution and they typically say something like, “We wanted to improve our billing efficiency.” Reaching maximum efficiency, however, requires using every tool at your disposal. Here are just a few of the time-saving tools offered by some clearinghouses to help increase your efficiency. Make sure you check with your clearinghouse to see which are available, and then make sure that you take full advantage of them:

Duplicate Claim Edit. This type of functionality allows you to work rejections faster and catch duplicate claims before they get to the payer. It usually works by comparing the current inbound file to previously sent claims. If you submit a claim that matches data provided previously, the claim will reject. In most systems the claim should not reject if the original is a non-active claim (i.e. deleted, cancelled, rejected, or filing complete). An optimal system will allow you to either “bypass” and resubmit the claim or cancel the submission.

Auto Cancel. Similar to Duplicate Claim Edit is Auto Cancel; you typically activate one of these functionalities or the other. Auto Cancel helps maintain workflow by preventing the need to manually cancel claims. With Auto Cancel, the rejected claim is automatically cancelled and the new inbound claim becomes the active claim. Practices that re-bill from their software may find Auto Cancel particularly useful. Read More

Practice management challenges, such as declining reimbursement and reducing days in A/R, are impacting all medical practices’ financial health. In order to address these challenges, ATD Resources adopted a strategy that has helped them realize revenue cycle improvements, including improving payment per case by 17% in less than one year. 

Join us on Thursday, September 30 at 1:00 PM EDT, for a complimentary webinar to learn what this strategy entails and how it can help all healthcare organizations focus on revenue cycle improvements that will enhance reimbursement.

In under an hour, you’ll hear Bette Warn, Executive Director at ATD Resources, discuss:

• Practical, hands-on approaches that will allow you to improve your bottom line.
• Strategies for identifying opportunities for change and improvement, as well as effective tactics for implementation.
• Tips and techniques for exploring and selecting technology and tools that will most effectively help you achieve your medical group objectives.

Register now.

Thank you to everyone who attended our August 24th webinar, 5010 – Opportunity or Chaos? Strategies to Survive the Transition. In this one hour event, Ken Bradley, Vice President of Strategic Planning at Navicure, and Bryan Koch, Vice President of Strategic Services at Navicure, discussed what your practice needs to do in order to prepare for the transition to HIPAA 5010, including:

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

It is important to fully understand the new 5010 HIPAA electronic standard, since it will impact all healthcare entities, including physician practices. 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.

To learn more about 5010, click here and download the recorded webinar.

How many secondary claims is your practice writing off?

The classic response to this question is a quick shoulder shrug, followed by the return query, “Why does it matter?” After all, the value of secondary claims is usually just a fraction of that associated with primary claims. Most practices believe it costs more in resources (especially staff time) to chase secondary payments than they’re worth.

In the past, that was probably true. But now, I’m urging all practices to take a second look at their secondaries. They may be worth more than you think.

As you consider your practice’s secondary claims, it’s important to keep in mind a very basic concept: Ultimately, the patient is the party responsible for paying you for your services. If you think back just a few decades, you’ll recall that patients used to file their own insurance claims. They were the ones who shouldered the burden of orchestrating all payment—including that of primary and secondary insurers.

While this arrangement made the patient’s reimbursement responsibility clear to all involved, it often created cash flow problems for practices. It’s hard to run a business when you’re waiting for someone else—someone with no real financial motivation—to get around to asking his or her insurance company to pay you! Read More

Just as people need blood circulating through their veins, so physician practices need revenue flowing through their bank accounts.

That requires many things: Confirming that patients are covered for the care providers deliver, submitting accurate claims that trigger prompt payment, posting payments quickly so resources are immediately available, ensuring no cash is left on the table.

Perhaps the most effective approach to managing all aspects of the revenue cycle is incorporating a Web-based application to manage receivables for improved cash flow and increased profitability. Read More

These days, you just can’t overemphasize how important it is to make sure every clinician is working at the top of his or her license. It simply isn’t cost-effective to have registered nurses, for instance, performing clerical duties.

Lots of practices seem to have this in mind when they ask about billing for their nurse practitioners (NPs), physician assistants (PAs), and other non-physician providers (NPPs). Most want to know about the basic advantages and disadvantages of billing for NPPs under their own Medicare billing numbers. Here’s my response:

The biggest advantage of allowing an NPP to bill under his/her own billing number is that you don’t have to worry about incident-to guidelines, which limit how and where an NPP-patient encounter can take place. Under his or her own number, for example, an NPP can see a new patient, or a patient in the hospital. By contrast, billing under the physician’s number requires direct personal supervision (that is, the physician must be in the office suite). NPPs also aren’t allowed to see new patients if they bill incident-to under the physician’s number.

The use of NPPs will allow your physicians freedom within their schedules to generate additional revenue through new patient encounters, surgery, etc. The main disadvantage is that payment under the NPP’s number is limited to 85% of the physician fee schedule reimbursement. If the same procedure or service is billed incident-to using the physician’s billing number, it is paid at 100% of the fee schedule amount. Read More

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