Thursday, September 20, 2018

Nothing in Your Revenue Cycle Takes Care of Itself. Five Mistakes Providers Make.


Healthcare providers with sub-performing accounts receivable will do well to take a close look at these five broad areas. This advice is especially important to high-volume billing offices affiliated with hospitals and healthcare systems. It’s not uncommon for institutional departments to falter in any of these five areas.

1. Not staying current with payer requirements. Payers often develop new tools and processes that can help you avoid slow payments and rejected claims. 
Make sure you have the latest technology (system updates), manuals, and contact information in place.

2. Failure to monitor the entire claims process: Without thorough monitoring of each step, staffers will waste countless hours analyzing denials and delays. The bottleneck that’s choking your cash flow may hide in a process you’ve inadvertently ignored.

3. Not resubmitting rejected claims: If you don’t feel you have access to data to support your claim, you might be reluctant to resubmit the rejects.

4. Failure to verify patient eligibility: Fully one quarter of practices never verify patient eligibility and copayment amounts. With constantly rising copayments, this can cost a practice dearly.

5. Not recognizing trends: Focusing on one claim at a time without stepping back to look at the
bigger picture will prevent you from seeing correctible errors in your processes.

Without a specific assignment, no one has time to analyze charges going out to make sure billing requirements have been met, and no one has time to analyze payments and adjustments coming in the door. The problems described in this article require analyzing trends and identifying where you’re missing out on revenue opportunities. 

The take-home lesson: Nothing in your revenue cycle “takes care of itself.” You must deliberately plan to analyze and evaluate your processes so that it becomes part of your routine. Otherwise, you could have a significant “leak” draining potential income from your practice.


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