Thank you to everyone who attended our latest webinar on January 5, Reimbursement Reality 2012: The Challenges – and Opportunities – for Medical Practices. Nationally recognized revenue cycle expert and author Elizabeth Woodcock, MBA, FACMPE, CPC, led the one-hour event, which focused on the challenges and opportunities reimbursement and payment programs offer for medical practices in 2012. During the webinar, she offered advice about how to:

• Leverage the key changes in 2012
• Manage the increase in patient financial security
• Successfully participate in the government’s incentive payment programs

To learn more about how your practice can stay as profitable as possible in 2012, click here  to download this webinar.

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Almost every industry article written today about revenue cycle focuses on how to streamline and improve the process. Although there are a lot of ways to streamline a practice’s revenue cycle, in my practice experience, I found that consistently implementing three key activities can help enhance staff workflow, reduce claim denials, and ultimately improve a practice’s bottom line.

The first of these activities is verifying insurance. While this may seem like a self-evident step, many practices neglect to perform this critical task—and for understandable reasons. Many practices simply don’t have the staff resources for what too often is still a manual chore. If they do perform it, practices often wait until the patient is standing at the front desk.

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For a long time, the practice I work at – North Platte Nebraska Physician Group – used a clearinghouse that made us feel as if we were sending claims into thin air. Although we were sending claims electronically, we never knew where they were in the processing cycle. Too often, we found ourselves bumped up against timely filing limits that hurt our reimbursement.

So we searched for a new clearinghouse that would provide the tools and the customer service we needed to improve our financial picture. After an in-depth review of our options, we selected an Internet-based organization for its terrific customer service, plain English reporting, and easy ability to view claims all the way through the revenue cycle. This new system has helped cut our timely filing reductions, decrease the number of duplicate claims, and improve our accounts receivable (A/R) tremendously.

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As the Business Office Manager for an orthopedic practice that sends out 650-700 claims a day, I rely on my clearinghouse to support efficient and accurate revenue cycle processes.  There are 23 physicians, 12 physician assistants, and 15 therapists at Orthopaedic Specialists of the Carolinas—and we’re growing. We need tools as dynamic as our practice.

That’s one reason why, in January 2008, we transitioned from our former traditional clearinghouse to a web-based clearinghouse solution. We’ve found some distinct advantages.

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Practices nationwide are being asked to accept more financial responsibility with patients and payers. As you tackle these challenges, it’s more important than ever to ensure your workflow is running at an optimal level. In this complimentary learn six specific workflow strategies that can help any practice improve overall efficiency, which will ultimately strengthen a practice’s bottom line.

Join us on Wednesday, May 25 at 1:00 PM EDT, for a free webinar: 6 Workflow Tips to Improve Practice Efficiencies.

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Cross-training staff is a time-intensive endeavor, especially if you do it correctly. That’s why many practices hesitate to make it a routine part of their operations. But properly cross-trained staff bring more to a practice than the ability to “cover” for one another during illnesses or vacations—they help improve the bottom line.

Thoroughness is the key to a good cross-training program. Offering front-desk staff only a high-level view of back-office operations, for instance, is not enough. Instead, solid cross-training should reveal in real detail how front-desk tasks affect the back-end, and vice versa.

The goal is to encourage a collective mindset by making all staff aware of the true effect their actions have on both patient care and the revenue cycle. An effective program must:

• be well-planned;
• engage your most experienced individuals in the “teaching” roles;
• map out specific learning objectives for each staff member; and
• ensure the learning objectives are met.

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The question came to me the other day: How does a clearinghouse fit into the broader scope of healthcare reform initiatives designed to reward quality care improvement? I think the answer has to do with practice productivity. While there are a number of ways to go about participating in incentive-based reform initiatives, practice productivity will be a key element in their success.

Think of all the things you must do at work every day. Everything takes time. So, let’s say your practice has decided to participate in the Physician Quality Reporting Initiative (PQRI). That single decision requires you to: read and understand the regulations; choose which PQRI measures your providers will track; and determine the most efficient methods for reporting, tracking, and getting reimbursed for those measures. It’s not something you can do in 20 minutes. 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 ›

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 ›