7 revenue cycle management tips to help independent medical practices
Medical practice acquisitions happen every day, and it’s not just the health systems that are buying. Private equity groups, Amazon/One Medical, and other healthcare disruptors are well aware of the value these practices provide. The good news is that there are many advantages to remaining an independent medical practice such as higher physician salaries, greater control over hiring decisions, and higher physician satisfaction. Not surprisingly, a substantial number of family practitioners remain on their own, according to a recent study. More specifically, 81% of solo practitioners and 35% of family practitioners in practices with 2–5 clinicians remained independent between 2017 and 2019.
Physicians who wish to remain independent must focus on providing high quality patient care while simultaneously improving revenue cycle management (RCM) processes. This article addresses seven ways that independent medical practices can boost RCM performance.
1. Form a network.
Medical practices that join an Accountable Care Organization (ACO) or Independent Physician Association (IPA) retain their independence while also simultaneously benefiting from the collective power of other providers. With an ACO, independent medical practices may receive profit shares, and with an IPA, they may be able to negotiate more favorable insurance contracts. Independent medical practices may also be able to form an alliance with local practices to create a mutually beneficial network of referrals or negotiate a professional services agreement (PSA) with local hospitals. With a PSA, physicians can maintain their independent practice while opting to work at the hospital part-time to supplement their income.
2. Consider RCM outsourcing.
Independent medical practices may not be able to afford the overhead costs and benefits associated with hiring and managing full-time medical billing staff. That’s where RCM outsourcing can help. When outsourcing, practices can ensure accurate and compliant coding and billing without incurring additional costs or employee turnover that continues to plague medical practices nationwide. An outsourced RCM vendor can also help the practice stay abreast of important regulatory changes that may require new policies, procedures, and workflows.
3. Focus on proactive denial management.
Proactive denial mitigation helps independent practices stop denials before they occur. What does this type of proactive approach entail? It’s about creating policies and procedures for how the independent medical practice will handle denials. This includes performing coding audits, monitoring payer remittance advice, identifying root causes of denials, and educating physicians and others about how to avoid those denials in the first place.
4. Improve patient collections.
On the front end of the revenue cycle, successful independent medical practices provide good faith estimates of services rendered, take the time to educate patients about their benefits and financial obligations, and require an up-front full or partial payment. Improving patient collections can have a significant impact on RCM and overall cashflow for the practice.
5. Choose the right EHR and practice management system.
These two technologies can make or break an independent medical practice. Full integration is critical; however, there are plenty of other questions to consider. For example, can the practice generate customizable and actionable reports? Are there additional costs for setup, training, upgrades, or customer support? What elements of patient engagement does the vendor provide? How intuitive is the technology for anyone who uses it?
6. Explore new services.
Some practices make the mistake of billing the same medical codes repeatedly without realizing that new codes are published annually. Some of these new codes may represent billable services that can help the practice grow and increase profitability.
7. Reinvest into the practice.
This could be in the form of higher wages to retain staff, new technology to engage patients and improve the patient experience, new equipment, and more. Don’t overlook marketing opportunities such as improving online visibility in both organic and paid avenues, optimizing Google My Business listings, and setting up inexpensive brand ads.
Conclusion
Remaining an independent medical practice in today’s competitive marketplace is an opportunity to provide high-quality patient care and a world-class patient experience. Practices that prioritize proactive RCM strategies will be able to seize this opportunity with ease. Learn how edgeMED can help at at https://www.edgemed.com and be sure to visit the Healthy Snacks Blog for more expert insights, best practices and industry trends.
