Seven tips to promote revenue integrity as you expand your medical practice
You’ve decided now is the time to expand your medical practice. Perhaps you’re hiring more providers, offering new services, opening additional locations, or a combination of all three. Regardless of your unique circumstances and goals, here are seven tips to promote revenue integrity as you expand your business.
1. Invest in training. Training is paramount as you are onboarding new employees and revenue cycle management (RCM) outsource partners. Everyone in the medical practice (i.e., front desk staff, providers, and medical coders and billers) plays an important role in revenue integrity. Budgeting for role-specific RCM education is important particularly if you plan to add new service lines that may require tricky medical codes, clinical documentation, and prior authorization.
2. Plan for medical coding, billing audits. With new services and providers comes the potential for medical coding denials and recoupments. That’s why medical coding audits, both initially and periodically thereafter, are necessary. You can perform internal audits, or you can work with an external auditor to get a sense of potential compliance vulnerabilities. Once you’ve identified the risk, take immediate steps to mitigate it. For example, you may need to provide additional education to a physician who doesn’t understand payer documentation requirements. Or you may need to re-examine prior authorization workflows to ensure compliance and revenue integrity.
3. Evaluate your RCM software. For example, do you use intuitive, cloud-based software? The goal is to avoid costly hardware fees that can easily add up as you expand your business. Are there additional costs for set-up, training, upgrades, or customer support? Ideally, the answer would be ‘no.’ Lowering or eliminating these costs means you have more capital available to invest in other areas as you grow your private practice.
4. Focus on patient retention. Without a concerted effort to keep the patients you already have, you run the risk of losing valuable revenue during the tricky ramp up period as you expand your business. There are many ways to do this. Some examples include sprucing up your waiting area, reducing patient wait times, and being more deliberate about creating a stellar patient experience, including a positive patient financial experience.
5. Consider automated workflows. Automation can be a lifesaver in terms of cost containment during a time when you may initially experience a negative return on investment associated with medical practice expansion. For example, you may be able to automate appointment reminders, eligibility, claim-status verification, and electronic remittance advice. You may also be able to leverage self-service options such as online scheduling, mobile patient check-in, and online bill pay that empower patients to play a greater role in their overall healthcare experience.
6. Leverage your data. Monitoring claim denials is critical as you grow your medical practice because revenue leakage can easily fall through the cracks. It’s important to drill down into the root causes of denial to accelerate payment, promote revenue integrity, and improve cashflow. Equally as important is the ability to monitor data in real-time, including aging accounts receivable, unposted insurance and patient payments, unbilled encounters, and no response claims. Again, having a stronghold on your data helps keep your revenue on track during a time when so many operational changes are occurring.
7. Explore outsourcing opportunities. Medical practices may find it more beneficial, cost-effective, and hassle-free to simply outsource their medical billing and collections to a full-service vendor that combines RCM professionals with advanced revenue cycle and technology solutions. Not having to worry about RCM allows you to focus on creating the best patient experience possible as you expand your medical practice.
Conclusion
Growing your medical practice requires many considerations, one of which is how to maintain revenue integrity. The good news? Proactive planning can mitigate risk and promote optimal cashflow even during times of intense operational changes. Partnering with the right medical billing and healthcare software vendor can make a big difference. Learn how edgeMED can help and be sure to check the Healthy Snacks blog for more expert insights, best practices and industry trends.
