In today’s economic environment, the timely collection of all earned revenue is not a luxury—it’s a necessity. That’s true for all practices – not just specialty ones. At Regional Urology Enterprise, for example, I’ve had to navigate the revenue pitfalls associated with imaging and radiation treatments. What I’ve learned, though, is practices that leverage technology to improve efficiency, streamline workflow, and proactively identify and respond to systemic issues can ensure they collect all the money they earn.

I consider my practice’s automated clearinghouse as one example of technology that kills two birds with one stone: it improves our overall performance while it also enhances the bottom line. We use it in a variety ways, but most notably to:

Read More ›

According to a recent study by the Medical Group Management Association®, 56% of practices in the United States have not scheduled internal testing for the 5010 conversion yet – even though the deadline is only six months away. If your practice is not prepared for 5010, it may impact your revenue cycle and your ability to successfully transition to ICD-10 in October 2013.

Regardless of whether your practice has started thinking about ICD-10, 5010 or not, there are a few key steps that every practice can take to ensure that they are prepared – and to ensure that your revenue stream won’t be impacted.

Read More ›

With reimbursements declining and costs increasing, managing your practice’s revenue cycle has never been more challenging or important. Over the last few years, practices have realized that they cannot afford to ignore the state of the economy or the pressures being placed on profits. Although the economy is showing signs of recovery, there are still other challenges that will impact revenue in the near future, including proposed Medicare cuts, the transition to ICD-10 and increased patient responsibility.

Adding to these trends is the pressure of implementing or upgrading an electronic health record (EHR) in order to achieve the government’s new requirements for ‘meaningful use.’ In the face of these pressures, now is an opportune time to re-examine your practice’s operational processes, especially your revenue cycle. You just may find that reengineering the revenue cycle will be the key to surviving – and thriving – in these turbulent times.

Read More ›

Negotiating payer contracts annually—or more often, if you can—is critical to the financial health of your practice. Granted, it’s not something most practices relish doing. Unless you have staff dedicated to the process, it can be a very time-consuming endeavor. Nevertheless, it’s the only way to ensure that you’re not leaving hard-earned dollars on the table as codes, relative value units (RVUs) and payer policies change.

As with most things, good contract negotiations start with solid preparation. All too often, however, I talk with practices that don’t even have copies of their current contracts and fee schedules. The very first step to prepare for negotiation is to make sure you have these two vitally important documents on hand. An electronic copy of your fee schedule is preferable, because it allows you to more easily compile essential reports.

Read More ›

Keeping track of prior authorization policies is difficult. Each health plan has its own set of requirements, which often change with regularity. Some Medicaid payers, for instance, want one “blanket” referral authorization before patients see certain specialists; the specialist isn’t required to obtain prior authorizations for every procedure. Other plans are much more restrictive, approving prior authorizations for specified procedures only when certain criteria/diagnosis’ are met.

The problem, of course, is that failure to obtain proper authorizations can have a drastic affect on practice income. The bottom line is simple: no authorization, no payment. Insurers won’t pay for procedures if the correct prior authorization isn’t received, and most contracts restrict you from billing the patient as well.

Read More ›

By now everyone in the healthcare industry has heard about the Version 5010 transition that will take place on Jan. 1, 2012. However, I am sure some people may still wonder exactly what this transition is—and how healthcare practices will benefit from the transition.

To understand how 5010 will help your practice, just imagine traveling to a country where everyone speaks a different dialect of the same language. In this environment, you are trying to conduct very important business transactions, where crucial details and nuances might be misinterpreted.

That is exactly the predicament the healthcare industry has faced for years. Now, however, Version 5010 of the electronic transaction standards promises to become a universal dictionary that will allow everyone to speak the same language, in the same dialect— essentially enabling apples-to-apples “conversations” among all healthcare entities. And that, in turn, will help every practice reap the benefits of improved claims filing, payment posting, eligibility verification, and other vital revenue cycle management (RCM) functions.

Read More ›

With reimbursements declining and costs increasing, managing your practice’s revenue cycle has never been more challenging or important.

Join us on Thursday, November 18 at 1:00 PM EST for a complimentary webinar to learn the specific steps you can take to improve your practice’s revenue cycle performance – even during these challenging economic times.

During this hour, you’ll hear nationally recognized revenue cycle expert and author, Elizabeth Woodcock, MBA, FACMPE, CPC discuss this detailed seven step approach, including:

1.  Review your payer contracts
2.  Implement a financial clearance process
3.  Collect payments at the time of service
4.  Deploy technology
5.  Prevent and manage denials
6.  Reengineer your collections cycle
7.  Develop a dashboard of revenue cycle indicators

Participants can earn up to 3.0 Continuing Education Units (CEU) from the American Academy of Professional Coders (AAPC) by attending the webinar and completing the pre-test and post-test.*

*This program has the prior approval of AAPC for 3 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

Register now.

You may recall that a few months ago I wrote a series of posts about ways to calculate key practice benchmarks, including days in accounts receivable, net collections percentage, accounts receivable greater than 90 days old and the ratio of billing staff to providers. Now, I’d like to share some ways to use that kind of data – and more – to truly optimize the revenue cycle.

In a recent discussion with the editor of an online journal, I brought up the fact that a variety of business intelligence tools now exist to help practices understand and improve their revenue cycles. Using these tools to drill down into specific details about each of your payers—instead of taking a more global perspective—can fundamentally change the way you assess your revenue streams. Read More ›

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.

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.