MedEvolve Blog

MedEvolve, Inc., a national provider of practice management (PM), revenue cycle management (RCM) and analytics software and services for physician practices, announced today the company’s bookings for third quarter fiscal year 2017 were the highest in its nearly 20-year history for the second quarter in a row. In addition to net new bookings in Q3, the company earned several MedEvolve Practice Management software and service renewals for two to three year commitments, which illustrates client loyalty and confidence as the company continues to launch market leading technology and services.

“The main catalyst for MedEvolve's recent success is our focus on providing data-driven solutions that give decision makers easy access to actionable financial and operational insights,” said Matt Rolfes, CEO of MedEvolve. “The opportunities of Big Data are not exclusive to larger organizations like hospitals and health systems, physician practices also need to leverage their data to find opportunity within their balance sheets and provide cash for growth.”

Important KPIs your specialty practice should measure and monitor on a regular basis­—and how to calculate them.

Managing the revenue cycle at a specialty practice is challenging. To be successful, Billing Managers and Practice Administrators should monitor certain Key Performance Indicators (KPIs) to better understand how effectively they are managing the practice's revenue cycle—especially billing, collections and payers.

MedEvolve’s RCM team has identified seven measures a specialty practice should be familiar with to ensure maximum financial and operational performance. However, it’s not enough just to monitor these metrics, you must take action when an issue is identified to resolve it so it does not continue to impact your revenue.  

When it comes to managing your revenue cycle in today’s healthcare climate,
it’s not about collecting every dollar—it’s about collecting every penny.

We found several key areas that are causing revenue leaks in specialty practices, and we recently presented a webinar to share this knowledge so practices can prevent it from happening in the future. 

You could be missing out on hundreds or thousands of dollars each month due to unresolved denials for the following common issues:

• Eligibility and Benefits Verification Gaps
• Increasing Patient Responsibility
• Avoidable Rejections and Denials
• Contractual Underpayments

Don’t let simple mistakes keep your practice from reaching its full revenue potential. 

Reason #1 – Maintain a Positive Patient Experience

Providing high quality patient care is the first priority of a specialty practice. However, this focus can become muddled when the emphasis on cutting-costs and staying in the black takes a front seat. Fortunately, with careful consideration, the patient experience does not have to suffer.

In fact, shifting the burden of RCM to a third party can often allow the practice to focus on what they do best—providing services that have value to the patient, rather than executing administrative functions. This could translate into increased patient face-time, fewer distractions for the provider, and the freedom to see more patients and generate additional revenue.

Reason #2 – Reduction in Overhead Costs

In-house billing also requires a significant investment in hardware and software, the added hassle of maintaining a server and upgrades, and an additional layer of compliance. When combined with the costs of training staff, any necessary certifications and the potentially damaging consequences of technical issues or outages, opting to outsource becomes an easy choice for many providers.

What’s more, many vendors are paid a percentage of collections, so this is an especially worthwhile investment during a period when revenue is decreasing at the practice.

Since doctors began taking the Hippocratic Oath, they have struggled with requiring payment for treatment of patients. For a doctor, it is their duty to treat a patient and sometimes they may be too willing to dismiss a copay or balance due because they empathize with a patient’s situation or maybe have a long-standing relationship. Collecting money that is owed is awkward for most business owners if a client does not immediately offer payment when it comes due. An unfortunate consequence of the increase in patient financial responsibility is that the practice of collecting on patient balances can turn you, your practice, and your staff into the enemy—the dreaded debt collector.

According to the U.S. Code of Federal Regulations, a practice must “make a reasonable effort to collect” on a patient bill before it can be considered a write-off.

What Defines a “Reasonable Effort to Collect?” 

With respect to Medicare and Medicaid, “reasonable effort to collect” has been interpreted to mean that the provider sends three statements to the patient and if the patient does not respond, the account may be written off.  Since third party billing rules can be difficult to decipher and differentiate, it’s typically a best practice to use Medicare and Medicaid as the standard for all payers.