(Little Rock, Arkansas – June 20, 2018) – MedEvolve, Inc., a national provider of practice management (PM), revenue cycle management (RCM) and analytics software and services for specialty practices, announced today the company’s Revenue Cycle Management (RCM) services team achieved its largest collection month in company history. This record month is a direct result of the operational redesign of the RCM department, its technology and processes, that took place in April—an effort the company and its clients will continue to see a positive impact from moving forward.
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.
Software Enables Providers to Leverage Their Data to Identify Areas for Improvement and make Informed Business Decisions
MedEvolve announced today the release of MedEvolve Practice Analytics. The solution gives specialty practices web and mobile access to important financial, operational and clinical information which provides the insight necessary to improve their overall performance.
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.
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.
Specialty practices are facing enormous challenges collecting on patient balances and managing healthcare payer relations. They must make patient collections an even greater priority than other providers or hospitals, as their margins for services are often much more narrow. Optimal revenue cycle management is a critical component to cutting costs and helping to ensure consistent cash flow.
Specialty practices need to have processes in place to ensure claims are submitted correctly the first time, to prevent costly denials, and they should make every effort to collect patient balances up front, or while the patient is in the office. Once the patient leaves, practices also should have a consistent process for delivering statements to patients and collection letters when necessary.If you don’t, you could be losing out on revenue that you need to stay in business.
Specialty practices are facing a number of challenges collecting the money that is owed to them in these times of increased patient financial responsibility. MedEvolve understands these challenges and we are constantly exploring ways to help our physician practice clients collect on their patient balances faster, and give their patients easy payment options. This new partnership with InstaMed will help MedEvolve’s clients expedite payment processing and provide additional means to collect.
With the rise in popularity of high-deductible health plans (HDHPs) comes an increased burden on your billing department and an increased burden on your patients. Most likely, your billing department is not accustomed to collecting money from patients, yet the need to has ramped up in the last few years. Today, your patients are most likely your largest payor, and if you don’t have the right process in place for collecting payment in a timely manner, your practice’s financial future could be in jeopardy.