MedEvolve Blog

Why Specialty Practices Should Focus on Margin

Posted by Ashley Moore on Jul 12, 2017 11:55:44 AM


With a greater portion of healthcare costs falling on the shoulders of patients, physicians are less likely to see the types of revenue streams they previously relied on. Unfortunately, reimbursements for medical services are not expected to increase, and are becoming more and more challenging to attain.

In the past, practices focused on increasing revenue to ensure financial success. Today, the focus must shift to decreasing cost—and therefore increasing margin. Physician practices cannot only rely on providing excellent care, they must also be business savvy and fiscally minded. 

No specialty practice wants to sacrifice patient care to increase its margin. We know physicians need to spend more time with patients and less time on administrative functions to sustain a healthy business. According to InstaMed's 2016 Trends in Healthcare Payments Seventh Annual Report, the average physician spends 21 percent of their day on non-clinical adminstrative tasks. Outsourcing some administrative functions, like billing and collections, can help reduce the administrative burden and is often more cost-effective than hiring additional staff.

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Topics: RCM Best Practices, Payer Management

Billing Metrics That Matter

Posted by Ashley Moore on Apr 19, 2017 8:55:39 AM


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.  

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Topics: RCM, RCM Best Practices, Patient Billing, Medical Billing, Payer Management

Insurance Contract Negotiations

Posted by MedEvolve RCM on Nov 10, 2016 2:00:30 PM

Negotiating insurance contracts is one of the least enjoyable aspects of any specialty practice. However, it's a necessary burden to maintain revenue, and the effort will be beneficial as you may achieve an increase in reimbursements of between 3 and 10 percent, according to Medical Economics. If anything, negotiation forces businesses to review their existing contracts so they know all the terms and conditions. Here's a run down of the negotiation process:

Do your homework
Assess your local market and see where you come up against other practices. What specialties, services or procedures do you offer, and how much competition do you face? Dr. Dean Gesme, an oncologist in Minnesota, recommended conducting a SWOT analysis, assessing your strengths, weaknesses, opportunities and threats to give you greater leverage during negotiations. 

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Topics: RCM, Revenue Cycle, Healthcare Regulations, RCM Best Practices, Compliance, Payer Management