Optimize Revenue Cycle Management

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Optimize Revenue Cycle Management
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What is Revenue Cycle Management?

• In a nutshell, it means taking steps to assure
  that you get paid for what you do and that you
  get paid in a timely fashion.
• The revenue cycle starts when the patient calls
  your office for an appointment and your staff
  captures the patients name, phone number, and
  maybe the name of their insurance company.
• The cycle ends when the balance on their account
  is zero.

Four steps to effective revenue cycle management

• Gather Data
• Verify Eligibility

• Use the Correct Numbers
• Automate the Process as Much as Possible

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GATHERING DATA

• Some practices say they cant afford to take the
  time on the phone when the patient calls for an
  appointment to collect insurance information.
  That means that the practice doesnt get to
  verify the patients insurance coverage before
  the appointment.
• If you dont verify coverage before the patient
  presents, you have to hold up rooming the patient
  to verify the insurance when they check in.
  Thats inefficient for everyone in the practice
  and often puts the whole schedule behind for the
  day.
• Pre-visit eligibility verification is a best
  practice that every physician office should
  strive to accomplish. If you find out that the
  patient is not covered for the visit a couple of
  days before the scheduled appointment, you can
  contact the patient to either get corrected
  information, or maybe even reschedule the patient
  if necessary.

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VARIFY ELIGIBILITY

• You can submit all patients on a days schedule
  in an electronic file and send it to a clearing
  house to verify eligibility for all appointed
  services (its called batching). Doing so will
  reduce the volume of denied claims.

• During a recent consulting engagement, a sampling
  of denials showed that 3,450 claims had been
  denied the first time theyd been sent through.
  Thats a first-pass denial rate of 6.9 the rate
  for better-performing practices is approximately
  3.
• Approximately two-thirds of the denials (2,270)
  were because of eligibility issues.
• The cost of managing those denials is
  approximately 25 per claim, which means that
  that group spends 18,900 every month to work
  denials that could be eliminated with an
  investment in batch eligibility for all scheduled
  appointments.
• It takes four individuals in the billing office
  to work the denied claims for that practice.

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USE THE CORRECT NUMBERS

• Accurate patient registration and billing
  information is a critical first step. Getting the
  charge posted with the CPT Service code and ICD-9
  diagnosis code on a timely basis is the next step
  in the revenue cycle process.
• Some practices hold their charge slips for a full
  day or even more. Sometimes they have someone
  cross referencing the appointment schedule
  against all the charge slips to be sure they have
  not missed charges, but that delays the charge
  posting and billing process by at least a day.
• Most practice management systems have a missing
  charge report that automates the cross-check
  process so there is no added value for holding
  onto charge slips for a day and, in fact, the
  process of holding charges increases the work
  load by forcing you to check each charge slip
  against the report, rather than simply hunting up
  the missed charge slips as identified by the
  report.
• If youre not using the missing charge report
  function, find out why not and consider using it.
  If your practice management system doesnt have
  the function, ask if it can be added, or do a
  cost-benefit analysis on switching systems.

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AUTOMATE MORE

• The revenue cycle process is enhanced with
  electronic claim submission and electronic
  remittance payment posting.
• Automated posting saves staff time and that time
  can be used to follow up on outstanding claims or
  overdue balances.
• The quickest way to a zero balance is to automate
  those tasks that do not require your billing
  staffs expertise and to use that expertise to
  communicate with the payers as needed.
• You can also shorten the revenue cycle by
  offering your patients online bill payment and
  e-statements.
• E-statements cost less than 60 of the price of a
  paper bill to produce.
• You pay your own bills online, why not invite
  your patients to do the same for your practice

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MDOffice Manager Contact Details
www.mdofficemanager.com
MDOManager
info_at_mdofficemanager.com
MDOfficemanager
812-248-9206
MDOfficemanager
1410 S Clark Blvd, Suite 2100, Clarksville,IN
47129
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Thank you!