Keeping up with the technological advancements in the healthcare field that appear daily can certainly be a difficult undertaking. Whether it’s Medicare's adoption of a billing coding system or the use of electronic data, many of these have since become standard practice in the medical field.
Now, the Affordable Care Act (ACA) has brought even more changes to our shores, with the federal government continuing to adjust healthcare rules and services as necessary. And whether you hate it or love it, automation and artificial intelligence has shown the greatest potential to modify our current healthcare financing practices as we know it.
This is why healthcare boards will need to have strong financial management skills both now and in the future. To assist you in making the best financial decisions, CPA Solutions has compiled a list of effective financial tactics you can implement at your healthcare center to help you meet your benchmarks and improve overall efficiency.
Billing Practices Your Healthcare Center Should Apply
Post Your Targets for Employees to See
Openly displaying these goals and rewarding staff members that meet or beat them is a terrific motivator that will make sure no one is dragging their feet around at work. These goals can be a variety of different things, from front-end collection to financial targets and business office goals.
Conduct a ‘Core Audit’
If a high percentage of your medical practice’s A/R is falling in the 90-day-and-over range, consider performing a comprehensive review of your current revenue cycle. This should start from the beginning of the billing and collections process (scheduling) to the end (completing the medical record).
Doing this will help determine any weak points within your internal controls that might be causing these late payments while potentially identifying other issues that might arise in the future.
Pay Close Attention to Secondary Payors
For cases in which you are filing claims with your secondary payors, it is important that your medical center’s office staff pays close attention to secondary payors’ rules and understands what they will pay you. If not, you could miss out on reimbursement opportunities.
A good practice to remember is to always encourage your biller to take a little more time to work with the secondary payor even before they send out the claim for the primary payor.
Identify Barriers Preventing Efficient Physician Dictation
A common issue that can hold up the billing process is slow physician dictation. If this is the case, you should work to identify the cause and see what you can do to assist the physician in completing dictation in a timelier manner.
Don’t Blindly Rely on Your Clearinghouse
While the working relationship between you and your software (as well as its vendor) is important, maintaining good relations with your clearinghouse and payors can often be a constant challenge with frequent finger-pointing and passing blame.
A tip for this is to dedicate a full-time staff member who does nothing but work as the liaison between the practice software, clearinghouse, and payors. You’ll want to make sure that any changes are communicated to the clearinghouse as soon as they happen so they can properly set up and process the claims.
The billing software should also have batch reports that will easily match uploaded batches in the clearinghouse reporting system.
Hold Collectors Accountable
To promote professional work etiquette, you should consider ways to hold your staff members accountable and carefully monitor their work.
With your collectors juggling many accounts, it can be easy for mistakes to occur. While the occasional error may not significantly harm your medical practice, the impact could be tremendous if it happens repeatedly and is not detected for a significant amount of time.
At the end of each day, take the effort to review what was collected during the day. Through this process, any mistakes that are caught will be fixed sooner while avoiding repeats in the future.
Cut Down Time Spent on Appeals
Payors may not be willing to share their rules, allowing your questions on policies to go unanswered while giving you incomplete responses. If you do not have a clear understanding of a payor’s rules, this can lead to significant—and potentially fruitless—time spent appealing rejected claims.
Since the payors won’t always help you out, you’ll need to look out for yourself.
The sooner patients receive the bill, the better your chances of getting paid. When a procedure is complete, the first thing an office normally does is submit its claim to the insurance company as quickly as possible.
If you want to increase the likelihood of patients paying their bills, you must send the request for payment as soon as possible, preferably right after the procedure is complete and the EOB has been received as people are more likely to pay their bills when they can remember what they received in exchange for their money.
While it certainly looks like a hefty list, the advice given above is just the tip of the iceberg.
These are just a few examples of how our CPA firm can help assist your practice to achieve its goals. CPA Solution’s mission is to help physicians like you be successful and profitable, providing consulting, accounting, and taxation services that are customized to meet your medical practice’s specialized needs. Just as we count on you for our physical health, we hope you can count on us for your financial health.