Tips for Better Revenue Cycle Management in a Medical Office
June 01, 2021
How would you characterize the success of your medical office? Is it a steady flow of patients, low denials, providers that take an active role in the business, a great clinical and administrative team? How about the financial health of the practice? It's hard to guide the ship in the right direction when you are too busy plugging holes in the galley.
Managing a busy medical practice can feel like playing a game of "Whack-a-Mole." There are always new issues popping up that require your attention. The upside is that it is never dull, and if you enjoy problem-solving and taking an active role in the medical office success, it can be a highly rewarding profession.
The pandemic has challenged the survival of all types of industries, including healthcare. Many traditional medical practices have had to reconfigure the patient care model, investing in technology to implement or expand telehealth services just to stay afloat. Many have suffered losses due to patients that are not keeping up with their care. What's more, insurance companies are pushing more financial responsibility to insured patients who can't afford to take on higher premiums and copays, adding more financial strain and risk.
It's hard to guide the ship in the right direction when you are busy plugging holes in the galley. This is not the workplace culture you want. Healthcare consultant Maxine Collins says it's still possible to improve your revenue cycle and now is a good time to take a hard look at fiscal fluctuations and make some good financial decisions.
Start by seeking answers to ever-changing healthcare regulations: How can you communicate more effectively with your carriers? Are there any opportunities to get some of their guidelines changed? If so, how? What tracking tools should you use to manage and respond to denials and/or underpayments?
Revenue Cycle Management generally means getting properly reimbursed for the quality of care and services rendered to your patients. You can start by looking at your processes for accurate insurance data collection and timely reporting to allow for better financial management decisions. Adapting processes to improve workflow and maximize efficiency will minimize expense. All these are essential pieces of a healthy revenue cycle.
"Managing patient responsibility, and establishing effective financial policies and procedures are critical for a healthy revenue cycle," Maxine says. "You can also look for opportunities to offset losses with new revenue streams, like taking on new ancillary services." Her quest is always to help providers and their teams bring in all the reimbursement rightfully due!
And physicians and providers are interested in improving the bottom line. Maxine asserts that medical office managers should leave no stone unturned when it comes to enhancing revenue. This includes educating your providers on coding changes, monitoring and updating fee schedules, managing patient responsibility, and establishing effective financial policies and procedures.
Practice Management Institute® (PMI) trains and certifies administrative professionals working in medical offices: medical office managers and staff working in coding, billing, auditing, and compliance. New and experienced professionals learn current guidelines and best practices to perform more effectively in their role. Providers and consultants involved in the business side of outpatient services also attend to understand the practical application of medical office administration guidelines.