I know exactly what you are thinking, who prescribes medication to someone who is not sick. Well we both know even the most healthiest person has to have some type of regimen to stay healthy. Whether they exercise, take vitamins and or work out daily. The same way we have to nourish our bodies, we have to do the same for our medical practices. You can’t expect to go out and lease a building, hire some staff members and then open your doors for business without first doing a market and practice analysis.
I know you are thinking that is crazy why do all those things? I am a doctor, people are going to be knocking down my door for services. Well guess what? The same day you open your medical practice, 25 other providers open their practice within a 50-mile radius of you. Oh let me think you’ve had a tech guy to approach you about creating a website and optimizing your search engine that guarantees when someone decides to Google your service you will be the first name to pop up on the list. Okay, now you have solved the problem in getting the patients in the door; what happens when the patients start coming in by the truckload and your current staff starts to cut corners forgetting to verify insurance benefits, collect copays and their wait time increased to an hour or longer? Let me guess you will continue on doing your same routine because the patients like you and needs your services. WRONG!!! This same mindset is why a lot of medical providers are closing their doors, have a current claim rejection rate of 33%, high patient receivables, waiting 120 days to be paid from insurance company, unable to take a vacation, spend all night charting records, and becoming physically sick themselves, etc. The problems are endless because they did not do a thorough check of their medical practice.
The healthcare industry has changed. Specifically, the days of easy money, easy practice start-ups and easy clients are gone. To be a successful medical practice you must start completing annual check-ups of your current medical practice and making adjustments to your prescription. Having a fancy Website, office space, and a lot of staff members cannot compete with an important tool -- S.O.A.P., which stands for Subjective, Objective, Assessment and Plan. You should complete a business assessment such as this every year.
How to use S.O.A.P.?
Subjective: Did your current medical biller allow you to tell them what symptoms you are experiencing? Did you provide them with your current receivable records for review?
Objective: Has your current biller written down his/her observations? What tests were performed?
Assessment: Were you given a thorough system check of why you are experiencing these problems?
Plan: Is your plan the same he/she gave the last 5 clients? When is your follow-up appointment? Are you happy with this plan?
Here at Triple E Medical Solutions LLC we understand the importance of revenue cycle management. Our trained, certified and licensed staff members specialize in making sure our clients are in compliance and most importantly getting paid in as little as14 days on average. If you are afraid that your current prescription has expired or it’s just time for your annual assessment, give Triple E Medical Solutions LLC a call today at 1-888-338-7293 and get your FREE Practice Analysis.
Tracie Clark, BSHIIM, HCM, RHIA, CMRM, is the Medical Billing Operations Director at Triple E Medical Solutions LLC. Contact her by telephone at 888-338-7293 ext.101 or fax 888-391-2109, email firstname.lastname@example.org.
If you find it more difficult to manage the entirety of your medical practice while maintaining the complexity and efficiency of your revenue cycle management, you should consider outsourcing.
Saves Time and Resources
It takes a great deal of time to hire, train, and maintain a revenue cycle management (RCM) staff. With the ever-changing regulations and protocols in the healthcare industry, outsourcing relieves your business of these burdens and allows you to focus on the core of your medical practice.
Enhances Revenue Generation
An RCM service will be able to generate a higher practice income through efficiencies of scale, broader experience with payors, resources dedicated to denial management, and self-pay follow-up, even after calculating the fees.
Decrease Days in A/R
Lack of follow up is a major contributor in lost revenue. Contributing factors such as timely filing issues, contractual allowances and write offs result in an increase in days in A/R.
A contemporary RCM service will provide customized monthly reports and analysis's that offer a deeper look at key metrics, allowing the organization to make better strategic decisions. This should include provider productivity, coding methods, resource management, enhanced patient care and myriad other practice specific ones.
Detailed Information (Cost/Utilization Patterns to Assist in Contract Negotiations)
Negotiating with payors in today’s environment is not only a tedious process, but puts a tremendous strain on providers and their management team. Having detailed, empirical historical information on an ongoing basis is a competitively enabling foundation when negotiating contracts.
A RCM should be your “Business Partner”, not your “Billing Company”. Clients should have dedicated personnel to handle your account almost as if they were your own employees.
Single Point of Accountability
When outsourcing, you have an accredited organization focused on the highest level of performance while providing checks and balances, making sure there are no inconsistencies. This allows for a more efficient billing process that offers a one stop solution.
Cost of Building an Internal Billing Operation
The costs and personnel complexities associated with implementing and running an internal billing operation is very high. A billing administrator is required to hire, train, certify and carry out a compliance plan. The average cost of recruiting, hiring and training a new employee is $3,500 (that does not include the decreased production caused by turnover). Technology, (hardware/software) resources, salary, benefits and office space are just a few contributing factors to the overwhelming expense of inhouse billing.
With the complex regulatory environment in the healthcare industry, the demands for billing knowledge and experience have become overwhelming for healthcare providers. Full service billing services are in demand partly because of their efficient administrative processes, HIPAA compliance, and their ability to stay contemporary with regulations and requirements.
End to End Management of IT includes the ability to meet the demand for skilled IT personnel, continuous assessment of your application (Industry Standards, HIPAA), hardware, network, heating, ventilation, HVAC, power, security, staffing, policies, procedures, upgrades, backups, monthly maintenance fees and the ability to integrate various systems and deploy new technologies. Offsite backups are required by HIPAA. And, an internal data backup plan is also required. You must establish and implement procedures to create and maintain retrievable exact copies of electronic protected health information.
Billing Business is Different From Your Core Business
Medical Billing is complex and requires 100% of your staff members time. Practices are looking to full service billing partners to allow the practice to focus on quality patient care.
Continuous Change in Healthcare Regulations
With the constant change in health regulations, providers no longer have the time and resources to dedicate to reading material, checking websites, interacting with payers and attending industry seminars. A quality RCM service staff will stay current on all of the aforementioned disciplines.
Don't wait until its to late and you find yourself in a predicament to have to close your practice because your revenue has dwindled away to nothing because you did not make a change. Whether we like it or not the healthcare industry is changing and if you don't jump on-board then you will be left in the past and out of your money. Don't lose your practice and your revenue. Get in the loop and get in compliance and allow dedicated personnel to take care of your business financial needs while you focus on the patients.