October, 2009- 5 Best Practices for Improving Your Revenue CycleBecker`s ASC Article about SmartFund Medical Best Practices Providers who want to improve their revenue cycle should follow the following five best practices, offered by SmartFund Medical, a complete revenue cycle management solution, for their coding, billing and collections.
1. Educate patients on their share of costs upfront. As patients’ deductibles increase and more patients enroll in high-deductible health plans, healthcare providers will see more patients who will be forced to pay a significant portion of their healthcare costs out of pocket. As a result, healthcare providers should prepare for this change and work to educate patients about how much money they will owe for a procedure before the day of surgery. “Set the expectation on the front end that they`re going to owe a balance … patients, in general, want to pay for their share of the services. However, if you send them a bill for several thousand dollars in the mail 4-5 months after a surgery, the bill is unexpected and they may not have the means to pay it,” says Dennis Keaton, patient payment program manager for SmartFund Medical.
According to Jennifer McLeod, medical implementation manager, many providers try to avoid discussing costs upfront in fear that it will deter patients. However, she says that educating the patient upfront is one of the easiest ways that providers can improve their collections on the back-end.
2. Offer payment plans before services are rendered. After explaining to patients what they will owe, ASCs should offer payment plans before services are rendered. Payment plans allow patients to pay their out-of-pocket expenses over time and budget for these expenses each month. “With payment plans, patients are set up on defined payments. They are expecting the bill each month, and they can budget for it, along with their other monthly expenses, such as a car or house note,” says Mr. Keaton.
3. “Scrub” claims for errors before submitting. SmartFund Medical uses the phrase “scrubbing out claims” to describe their process of reviewing claims for errors before submitting them to payors. “Reviewing all claims for compliance issues, diagnosis issues and other possible coding errors greatly improves the chance of having a clean claim, which reduces days in A/R and increases your receivables,” says Ms. McLeod.
4. Monitor the status of claims. Many healthcare providers who outsource claims fail to monitor the status of individual claims and instead rely only on monthly statements to assess their revenue cycle. “When you`re turning over your billing and coding to a third party, sometimes you may not ever see a claim again until it shows up on a monthly statement,” says Casey Sullivan, marketing director. “Providers should try to find outsourced solutions that allow them to see the status of claims at anytime they wish. This gives practices a much better idea about their cash flow.”
5. Don`t blame it on collections. Many healthcare providers are quick to blame poor collections processes for outstanding A/R. “In reality, however, issues with billing are usually the problem. If you have $500,000 in outstanding insurance A/R past 60 days, you clearly have a billing problem,” says Mr. Keaton. “Providers can improve their revenue cycle by not denying the problem and beginning to look at what`s going wrong on the billing side.”
Written By:Lindsey Dunn
Submitted By:Casey SullivanLink: