Medical Practice Management: 7 Tips for Achieving Financial Health in Your Practice

The following information has been excerpted from a Whitepaper titled €œGetting Your Practice €˜In the Zone €™: 7 Tips for Achieving & Sustaining Financial Health in Your Practice, € published by athenahealth, Inc.

Click here to access a free, full-text PDF file of this Whitepaper.

Tip #1: Convert “lost” patient time into billable time.

According to recent studies, more than a quarter of all cancelled appointments are never filled, and up to 6% of scheduled patients don’t show up.

  • Schedule appointment requests within 1 week to reduce likelihood of no-shows, and create a waiting list to draw on for filling open time (31% of appointments scheduled more than 20 days out are rescheduled and 8% are no shows).
  • Include sufficient open time to accommodate same-day appointments, which help compensate for revenue lost to cancellations and no-shows.
  • Match your appointment capacity to patient demand to reduce backlog and schedule churn.

No-Show & Patient Cancellation Rate by Scheduling Day
Tip #2: Pre-process patients to ensure efficient, profitable appointments.

Proactively contact patients prior to their appointment to resolve eligibility issues, collect past-due balances, or discuss upcoming estimated out-of-pocket dollars. It is more effective to manage these financial processes before the patient arrives to reduce inconvenience.

Tip #3: Don’t let money walk out the door.

Patient financial responsibility accounts for nearly 20% of an average practice €™s accounts receivable, yet 81% of self-pay net revenues are never recovered.

  • Let patients know your financial policies and expected payments before appointments when possible.
  • Collect co-pays/coinsurance/deductibles €“ new and past due €“ at appointments.
  • Use a system that offers real-time claim adjudication, allowing you to collect on-the-spot, accurate, patient obligations.
  • Establish automated payment plans for monthly credit card installments to eliminate paper statements, multi-check processing, and time-consuming follow-up.
  • Consider using a patient portal that allows patients to pay bills online.

Tip #4: Bill appointments immediately, and make sure claims are clean and sent promptly.

Most practices have significant charge-entry lag, which decreases claim accuracy and volume.

  • Convert your services into charges in real time to get paid faster.
  • Cross-train staff to help handle high-volume periods or non €“office-based care.
  • Review daily charges to ensure completeness and accuracy and follow-up immediately on any missing items.

Tip #5: Swiftly review and appeal denials and underpays.

The vigilance required for addressing denials and underpays is time intensive and expensive.

  • Put systematic processes in place for each possible outcome:
    • No response back from a payer
    • Receiving a denial
    • Billing patients for their portion of the charges
    • Patient nonpayment
  • Follow up on uncollected self-pay balances to ensure patients are clear about their obligations.

Tip #6: Track, benchmark, and improve practice performance.

It is critical to monitor practice operations, benchmarking them against the performance of similar practices.

  • Review overall practice performance monthly (e.g., payer performance, schedule utilization, denial trends).
  • Analyze where staff can be cross-trained to perform critical tasks during busy periods.
  • Identify non-value-added activities that may be distracting staff; promote streamlining their workflows.
  • Review staff performance and provide incentives for improvement.
  • Assess which practice services produce the most revenue and use this assessment to improve patient mix.

Your practice management vendor should provide these tools, as well as an account manager to coach you on taking advantage of their services to optimize each area of practice performance.

Tip #7: Figure out what you can do, can’t do, and could do better.

  • Examine which practice tasks are revenue-enhancing (e.g., ancillary services and marketing) vs. cost-producing (e.g., fax filing and calling patients with lab results); cross-train staff to handle each as workflow requires.
  • Determine the amount of time staff spends on tasks that could be more economically offloaded to practice management vendors (e.g., document management, patient eligibility determination, claim submission/follow-up/posting), so that staff can focus on revenue-enhancing tasks such as payer contracting.

Access the athenahealth WHITEPAPER to view a full-text version of the information provided above. For more information on how to optimize practice performance and revenue, visit:

Telephone: 1-800-981-5084

© 2013 athenahealth

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