By Jill Arena, FACMPE – Managing Partner, Health e Practices, LLC
Doctors want to deliver better care. That’s why they went to medical school and became physicians. Yet, to actually deliver better care day in and day out, physicians must also run a successful clinic or work for someone who does. The two go hand-in-hand.
Did you know that medical professionals spend more than any other industry to bill and collect for services they’ve already rendered to patients? It’s astounding. Clinics have certified experts, highly trained coders and powerful practice management software on their side, yet it remains an expensive and frustrating proposition just to get paid for the care provided to patients. Let’s explore why this is so.
Frequently, offices entrust their entire cash flow to a clerical person (or team) who is paid $14-15 per hour. If these billers do not receive appropriate on-the-job training, this can lead to hundreds of thousands of dollars being left on the table.
Hopefully, you can’t relate to the following story. One practice we worked with came to us with accounts receivable in excess of $833,000; Days in A/R that were greater than 73; and work queues of unfinished claims that needed follow up in excess of 600.
Clearly, some clinics are feeling real pain when it comes to their revenue cycle. The good news is there is a well-defined path to A/R recovery and ongoing wellness. First off, all profitable clinics have key performance indicators (KPIs) in place.
Key performance indicators include:
- Number of days in Accounts Receivable as measured against MGMA national benchmarks
- Total dollars in Accounts Receivable as measured against MGMA national benchmarks
- Percentage of clean claims
- Payer mix
- Overall aging within the Accounts Receivable
- Coding patterns and distributions for high-volume CPT codes
Each of these KPIs can be tracked and graphed for both a numerical and a visual output each month. This way, any degradation of performance can be addressed immediately.
Medical practices are businesses and business need cash flow to operate. Constant monitoring of the important KPIs, along with written workflows, active tracking mechanisms and a commitment to staff training will greatly improve the financial performance of the clinic.
If you’d like to learn how Health e Practices can improve your cash flow and maximize the insurance reimbursement you have earned and deserve, visit our Revenue Cycle Management page at healtheps.com.