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BILLING AND COLLECTIONS

4 best practices to help optimize your processes and increase your reimbursements

By Ranadene (Randi) K. Tapio, MBA, CMRS, CMC, Guest Contributor  bio

Revenue Cycle Management is multi-faceted. There may not be a right or wrong way as far as your process goes, but there are tips, tricks, and best practices that can optimize the process, and in turn, your reimbursements.

After years of experience working with varying sized and specialty practices, the following are some ways our clients have increased their reimbursements.

1. Work your aged accounts list. Often times, the aged accounts list gets neglected because it’s not fun to make these calls and put the required effort in. Your aged accounts list, however, is a great source of revenue that has already been earned. By keeping this list current, there’s a better chance of recovering these receivables.

  • Establish priorities within your aged accounts list, setting highest priority to high-dollar accounts and third-party payers. These accounts are more likely to remit payment.
  • Assign the aged accounts to a specific person within the practice. Having ownership and consistency will help keep the list to a minimum.
  • Use automation to your practice’s advantage by setting up frequent automatic reminders for patient-pay accounts and notifications for delayed or denied claims from payers.

2. Optimize your coding resources. Having experienced, professional, and knowledgeable coders can make a significant difference in your reimbursements.

  • Ensure that your coders are certified. With all of the changes to the coding regulations in the past few years, continuing education and certification can prove vital for your coding staff.
  • If your practice is having trouble finding or retaining experienced coders, consider hiring an outsourced coding provider. Having staff or an outsourced coding provider that is certified can mean fewer mistakes, fewer denials, and more reimbursements for your practice.
  • Network with coding professionals/associations to optimize your process. Others that know your specialty can be a great resource for fine tuning your coding strategies. Optimize your network and share best practices with each other. If you don’t have a network of professional coders/association involvement, consider consulting an outsourced coding provider who has worked with many similar practices. They can be a great resource for what works and what doesn’t.

3. Establish your process and roles. From scheduling to collecting, having a process that is understood and repeatable will ensure maximized reimbursements for your practice.

  • Along with help from your team, identify each step in your revenue cycle process. Talk through each step—how it affects the patient, the provider, and the reimbursement process. Then, assign each step to someone within the practice. Each step should be owned by someone who can bring innovative ideas to the table and improve the process over time.
  • Identify clear roles and responsibilities within the process. Your practice likely has skilled personnel who have experience and expertise in claims processing, but it’s unlikely that one person can handle the revenue cycle from beginning to end. Once you understand your process, create roles and responsibilities for each stage. When team members have clearly identified responsibilities, they’re more likely to take ownership and succeed.

4. Optimize automation and technology. Many EHR and PM software have automation modules that will help you optimize your revenue cycle process by providing notifications, reminders, and follow-up reports. When used correctly, these modules can play a significant role in reducing menial tasks and improving efficiencies.

  • Appointment Reminders. According to MGMA, 5-7% of appointments result in no-shows. Broken appointments can cause wasted time and missed revenue for practices. Appointment reminders are a quick and easy way to reduce no-shows and improve patient satisfaction.
  • Patient Balances. Patients are becoming more self-serving and they want their information on their timeline. Make it available to them. Using patient portals, email statements, or text notifications, allows patients to check their balance without taking precious time from your administrative staff.
  • Collections Notices. The millennial generation is known for responding better to notifications via text or email. Use these venues to send out notifications or reminders regarding upcoming or past due accounts.

Conclusion

There are as many ways to increase your reimbursements as there are ways to manage your revenue cycle. Having someone who knows what a successful revenue cycle looks like and how to implement the changes needed is key.

Ranadene Tapio is the president of MedCycle Solutions, which provides Revenue Cycle Management, Credentialing, Outsourced Coding, and Consulting Services to a number of healthcare providers in a variety of specialties.  She holds an MBA in Healthcare Administration & Management and multiple professional certifications. You can reach her at Randi@MedCycleSolutions.com or 320-290-6448.


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