Topics: Medical Billing, Revenue Cycle Management, Practice Management, Medical Billing Company
To keep the wheels turning at your practice, you periodically review reports on many different aspects of your operations: patient encounters and no-shows; per-provider performance metrics; revenue cycle effectiveness. If you’re like most doctors and medical practice management, you review your data with a dual mindset: a reflective approach (“How did we do last quarter?”) and eye for improvement (“Let’s do 10% better this time.”)
Of course, that’s what you should do... but it’s not ALL you should do.
Whether you’re running a group practice or a single-practitioner practice, your front- and back-office operations produce a wealth of useful data that you’re likely not utilizing to full advantage. Try these three techniques, then get creative to see what other applications you can come up with.
Schedule That Vacation: By nature, some months and seasons are busier than others. So when you only review monthly or quarterly performance reports, you know essentially what to expect before you even open the files.
Drilling down to daily and weekly data, however, can help you spot unexpected trends – like whether you earn more income in the second week of a given month (or day of a given week) than you do in the third. That information can help you better schedule office closures and your doctors’ vacation days, mitigating their impact on your income.
Cut a Pesky Payer Loose: If you only focus on back-office basics like first-pass resolution and overall revenue, you’re undoubtedly missing highly valuable information on payer-specific trends. Don’t lump all your contracted payers into a heap and treat them like a single unit – put data to work and go deeper to see how quickly and appropriately each of them executes on your claims.
Assess reports to see which payers are taking longest to reimburse on your claims, and which are reimbursing less for certain procedures than others. Calculate whether the value of continuing to accept an under-delivering payer is worth what you’re losing; if only a handful of your patients are covered by that insurer, working with them may be more trouble than it’s worth.
Learn Your Triggers: You already know that your claims denial rate is one of the most important metrics of your practice management. But focusing only on how many claims are denied shouldn’t be the endgame. What should? Knowing which claims for which procedures are getting denied (and by whom, and why).
Go deep into your medical billing data to understand which encounters are ‘triggers’ for potential (or likely) denials and make sure you’re resubmitting claims for them if they’re being denied inappropriately. If not, just as in the above example, assess the value of continuing to perform the procedure and bill the payer. Cutting your losses can sometimes be a great move for your bottom line!
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