Does it seem like you’re working more hours on your practice yet not making more money? It may be because you’ve got several “leaks” in your practice.
These leaks are areas in your practice that unknown to you do nothing but consume your revenue. From before the actual patient visit to well after the patient leaves the clinic, medical practices can lose a lot of money because of these leaks. Could your practice be among those plagued by these leaks? Read on to find out and plug those leaks before they pull the plug on your practice.
Before the Patient Visit
Even before the actual patient visit, practices can lose a significant amount of income due to negligence in verifying insurance eligibility, which leads to claim denials and delays. According to the American Medical Association (AMA) 25% of private payer denials are directly caused by patients being ineligible for benefits.
Another cause of income loss? Overstaffing or unqualified staff. Overstaffing can eat up a significant amount of your practice’s income, with salaries taking up to a quarter of a practice’s costs. Make sure that all members of your staff are efficient in their duties and prioritize quality over quantity in order to avoid this income drain. You also need to make sure that each staff member is well-trained and competent. Their collection of accurate patient information is key to avoiding costly denials and delays, and their diligence in the overall management of the practice crucial to its success.
During the Visit
When the patient comes in it is vital that you collect copays before the patient leaves. This is important not only because copays now constitute a much larger percentage of a practice’s total revenue, but also because it becomes more and more difficult to collect once the patient leaves the clinic. This difficulty in collection can lead to tens and thousands of dollars in losses per year.
After the Visit
After the patient visit, revenue leaks can become even more apparent. According to the Healthcare Billing and Management Association, the Centers for Medicare and Medicaid Services denies 30% of claims due to errors on the first submission. Of these denied claims around 60% do not get resubmitted, leaving practices unpaid for their services. Even if a practice is paid on the first try, the AMA reports that 1 in every 10 payments is incorrect. To ensure proper payments, it’s crucial for practices to double-check and follow-up on claims, handle denials systematically and make improvements to limit future denials.
Coding is another area of concern. Improper coding and downcoding can both lead to improperly or insufficiently paid services, resulting in thousands of dollars in revenue losses. Improper coding and downcoding may also attract scrutiny and penalties from auditors or insurance companies.
Such problems as uncertainty in coding can be avoided through the use of Electronic Health Records (EHR), and many other income leaks can be prevented by it as well. Research done by the University of Michigan has revealed that many practices will lose around $40,000 in five years for failure to leverage the benefits of their EHR systems. Properly leveraging EHRs is key therefore to preventing such sources of revenue loss as inaccurate coding and rejected claims.
If you’re in need of a reliable EHR, Park Medical Billing can help. We’ve developed a powerful, easy-to-use and cost-effective electronic medical record system that can be tailored to the specific needs of any practice. With this industry-leading technology and our trusted array of services, you can be assured of more efficient operations and better control over your revenue.
To learn more about our offerings, please contact us on 1-201-585-7306.