Are Common Revenue Cycle Management Mistakes Losing You Money?

According to the American Medical Group Association (AMGA), system-affiliated medical groups lose nearly $250,000 per physician annually. Revenue cycle labor shortages, registration missteps, and documentation errors all potentially lead to increases in controllable denials.

Is your healthcare facility making Revenue Cycle Management missteps?

In what ways are your staff missing out on claims reimbursement and cash flow wins?

Here are 10 areas where your healthcare organization could be leaving money on the table:

1. No Shows – How fast are no show and canceled appointments rescheduled? To minimize missed revenue, spend 15-20 minutes per day rescheduling missed appointments. You’ll have the highest success rescheduling calls if performed the same day.
2. Insurance Eligibility – Your office staff confirms insurance eligibility prior to appointment date, but are they reconfirming during patient check in? If your staff spent 10 minutes confirming insurance at check in, it can easily save two to three hours of back office staff time by preventing avoidable denials.
3. Copay Collection – Do you communicate with your patients about expected copays within the two initial critical steps of patient communication – when creating appointments and during reminder calls. Staff can easily boost copay collection by informing patients during these two interactions of their expected payment.
4. Inconsistent Processes – A new staff member may not have been properly trained, or staff can grow complacent over time. In either instance, they can perform revenue cycle steps inconsistently. By using reference guides, you can easily describe workflows and encourage adherence to established processes. You can also perform spot audits to ensure critical workflows are being followed.
5. Denial Trends – What are your top 10 reasons for denial? Have denial shifts occurred since the last quarter? These answers demand consistent, detailed denial reports and root cause analysis. If your coding team needs help, schedule a training webinar. Or, if chart documentation is lacking, one-on-one training sessions can dramatically decrease preventable denials.
6. Revenue Cycle Leakage – Which revenue cycle phase is your weakest point? Front-end, middle, or back-end? Successful CFOs know which revenue cycle phase is the weakest. Report out lag times for charge entry, claim generation, and remit posting. A bad DNFB (discharged, not final billed) used to mean a coding backlog, but, today, revenue cycle issues are very complex and more costly.
7. Payment Plans – Cut A/R Days and increase cash with payment plans based on patient financial ability. Offer a discount to true self-pay patients if the balance is promptly paid in full or paid prior to their appointment. Is your practice offering what your peer facilities are offering their patients?
8. Ongoing Training – Do you offer new hire training? Most companies do, but do you offer continuing education for existing staff? Ongoing training is critical for proper EHR (electronic health record) use today. Include quick guides, visual examples, and checklists. Refresher training can quickly curb end-user error and stop a problem before it becomes an issue.
9. Incomplete Claims Data – Are you plagued with denials for missing authorization numbers? Ensure your claims are compliant with payer coverage regulations. Encourage proper workflows and eliminate wasting valuable time resubmitting claims.
10. Statistical Data – Share reports with patient onboarding locations to encourage competition. Create reports by location, total copay collected, rate of missed or canceled appointments, and denials for incorrect insurance. Recognize staff with performance incentives, achievement certificates, or award a day off for annual winners. Get creative!

Our team of fully certified staff has a depth of experience in EHR training, database expertise, technical support, and billing subject matter experts. Contact us today for more information on our Revenue Cycle Management service.