Submitted by Antonio Arias, MBA, CHBME on Tue, 01/13/2015 - 10:00

Top medical billing risks to your revenue

Stop Risking Your Revenue

Are You Failing to Spot the Top Risks to Your Revenue?

With payer reimbursements continuing to decline, providers and medical practice managers know that they can’t afford to let revenue slip through the cracks. Yet many are losing money without even realizing it, simply because they aren’t noticing areas where they’re underperforming, making mistakes, or operating inefficiently.

Starting the new year off on the right foot means mitigating risks appropriately… and “risk management” is just as critical to your revenue cycle as it is to patient interactions. Review your performance in each of these risk factor-laden areas of your revenue cycle.

Scheduling

Your appointment book may be the number one source of missed revenue. Every slot in each day’s schedule is an opportunity to bring money into your practice. Are you taking full advantage?

Audit your schedules regularly to see when and where you’re leaving appointments unbooked or receiving more cancellations than you should. Monitor for trends and times when patients no-show, and double-book accordingly. Train front-desk personnel to schedule strategically – the time spent on education will earn your practice money in the long run.

Physician Productivity

Then again, it’s hard to optimize your schedule if you’re accommodating a provider with less-than-ideal habits. Review every physicians’ performance: Are they slow to end visits and finish documentation, putting daily agendas behind? Are they conducting low-reimbursement visits too frequently? 

Consider ways to maximize revenue based on physician productivity. Maybe bringing a non-physician practitioner aboard your practice for routine patient encounters – check-ups, follow-ups, etc. – would free up your docs for higher-value visits. Maybe a newer physician needs to be coached by a more experienced one about the average time that should be spent on various kinds of patient encounters. Make it clear to your providers that their conduct has a direct impact on revenue.

Copay Collection

According to revenue figures from a Medical Group Management Association survey, 20 percent of office revenues come from patient copays — yet most practices only collect 60 percent of those fees. That means the average practice is leaving 8 percent of its total annual revenue on the table.

Make it clear to your staff that they must estimate each patient’s copay responsibility before his or her visit and must ask for payment when the patient arrives. Set a goal of collecting 100 percent of all copays at the time of service. (If you ask for a daily report that identifies if and why any copay was not collected, collections should go up.)

Billing & Coding

Underpricing, undercoding, missed charges, and unreimbursed claims can cost you thousands in lost revenue. (Some estimate as much as 3-5 percent of revenue is lost annually because practices fail to bill for services and procedures performed.) And if your practice is guilty of medical billing errors, you may be hurting your patients financially by over-charging them or placing them at odds with their insurance companies.

Audit your billing and coding operations to see if your staff is making errors. Give them additional training and refine your revenue cycle policies if that’s the case. Or, consider working with a medical billing company. Contracting with a trusted medical billing service is a proven way to lower your denial rate and increase your revenue.

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Topics: Medical Billing, Revenue Cycle Management, managed care, medical billing top revenue risks, medical billing top risks to your revenue

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