6 Pillars for a Healthy Cash Flow for Your Medical Practice

Struggling to keep AR days down? Here are some pro tips from Lister, to help you in your Revenue Cycle Management (RCM) journey.

We understand that efficient Accounts Receivable (AR) management is critical to the cash flow of a healthcare service organization. As a Centre Owner, Practice Head or Medical Office Manager, keeping AR days as low as possible is one of the biggest priorities as this means the cashflow of your Center, anywhere in the US, is better and predictable. This makes running your business easier.

· Get the Basics Right

First things first, let’s get back to basics. The staff at your practice must have a proper process in place. This means that there should be proper documentation, steps outlined, and Standard Operating Processes (SOPs) in place for every step of the journey, from when a patient is scheduled to filing the claim and receiving the remittance from the Insurance Payor.  Here are some things to keep in mind:

      
· Check Patient Insurance Details when they arrive at your practice – This is the most important step as a robust process here can save you from complications and headaches later, and prevent unnecessary delays. Ensure that the patient’s insurance is up to date, and if possible, check and
see if their deductibles are met so that you can let them know if the insurance will cover this visit or not. This keeps both the Practice and the patient well prepared. 

      
· Embrace Automation and Software – While this step can feel daunting if your Center has relied on cheques and other older forms of payments from the insurance, now might be a good time to upgrade your systems and leverage EDI (Electronic Data Interchange) and ERA (Electronic Remittance Advice) enrolments with most of the payers to send the claims electronically. It helps receive the remittance from insurance 
quickly, reduces the trips to the banks to submit the cheques and removes manual interventions at these steps, thereby reducing the dependence on people in the process. With the advancements in these forms of payment, you can be assured that your payments will be processed on time.

          · Dedicated Resource to Oversee Medical Billing – This is one where we feel many practices drop the ball. Having a dedicated resource

     sounds like it’s an added expense but think about it, this is the process that’s attached to most of the revenue your Center gets and not having a
dedicated resource will only hurt your practice in the long run. You can either get an existing employee to take it up full-time or hire someone to oversee all medical billing operations for your practice. They can coordinate with the medical billing team (in-house/vendor), coordinate with doctors to ensure charts are updated promptly, and track payments from the payors.

· Accurate Claim Submissions

Streamlining your documentation helps minimize billing errors and delays. If you submit claims promptly with accurate information, you can easily avoid rejections and denials. Submitting error-free claims at first instance goes a long way to help get faster claims. Delay in submission and/ or inaccurate submission can lead to rejections and cascade into increased AR days. It starts with capturing accurate information when the patient is scheduled and goes all the way up to submitting clean claims to insurance.

· Keep Patients in the Loop

It’s critical to keep in touch with patients about any billing issues that may crop up. As an RCM company, we’ve also seen how effective it can be when, in specific cases, patients directly speak to insurers in the event of a claim delay or rejection. With experience, we have been able to detect cases where a patient, whose claim has been rejected, could help get a claim processed faster by insurance. This is something you should try.

· Denial Management

By regularly monitoring outstanding patient accounts, one can fix issues early. A thorough analysis of the root cause of denials can bring out the coding and billing errors that cause the denials. Once the errors are fixed, claims have to be resubmitted within a reasonable time. If a claim is denied, you should analyze why the codes were denied, recommend changes, and resubmit the claim to ensure that a healthy cash flow is
maintained. The periodic analysis can then help prevent the recurrence of similar claim denials. 

Want help in analyzing your existing medical billing setup and see how it can be improved? Contact us for a FREE Audit and we can tell you how you can make your current setup more efficient. Click here to Connect with Us to contact us for more details.

· Systematic Follow-up Process for Unpaid Claims

You must regularly train associates to review and update coding revisions, be up-to-date in process changes, have a systematic follow-up process for unpaid claims; and have an effective process for quickly and accurately addressing the denials received from insurance.

· Monitor KPI to Track the Performance of Billing Processes

Your KPIs (Key performance indicators) like AR days, and outstanding % in 90 days bucket must be tracked regularly to enable early detection of rejections/ delays. Schedule weekly or bi-weekly calls to your medical billing team and provide responses on the action items promptly.

Build strong documentation, claims, and denial management processes to work on your 90+ claims and maintain the 90+ AR grid below 10%.

Need help to reduce your AR? Talk to us today! Get a FREE audit done. Click here to Connect with Us