Eight revenue cycle management tips to end the year financially strong
Ending the year financially strong is important. Why? It helps set medical practices up for financial success in the new year. To promote a strong financial year’s end, it’s critical to take inventory of current revenue cycle management (RCM) processes, identify areas of weakness, and devise best practice solutions. Consider these eight RCM tips when creating your year-end financial checklist.
1. Submit any unbilled claims. If your medical practice doesn’t have strong RCM workflows in place, you probably struggle with timely filing and could even have a backlog of unbilled claims that can cause significant cashflow problems. Submitting these claims helps you avoid timely filing denials and capture critical revenue to which you’re entitled. Take the time to run a report of all unbilled claims, review claim data, scrub that data for potential errors, and submit these claims as soon as possible.
2. Follow up on unpaid patient balances. In an era of high deductible health plans, unpaid patient balances can add up quickly for your medical practice. Now is the time to remind patients of any outstanding amounts owed and educate them on how they can make a payment via the patient portal, your integrated credit card system, or a variety of other methods.
3. Perform payment reconciliation. If you don’t already have a process in place to review, post, and automatically compare payments against fee schedules, now is the time to create one. Take a look back at the last few months to analyze, correct, reprocess, or appeal any unpaid and underpaid medical claims.
4. Evaluate your financial progress. Now is a great time to assess any financial goals you set in the previous year. For example, did you strive to increase patient volume? Reduce denials? Improve quality data? Reduce days in accounts receivable?
Did your medical practice accomplish these goals? If not, why? Can you move any of these goals to next year’s financial plan? Remember: When setting a goal, try to use the SMART acronym, meaning goals should be specific, measurable, attainable, relevant, and timely. For example, instead of saying you want to reduce denials, consider setting a goal of reducing Medicare denials by 2% over the course of six months.
5. Review expenses. Do you know just how much money your medical practice spends each month and specifically how you spend it? Tracking your expenses can help you identifying areas of unnecessary spending as well as opportunities to pursue lower-cost alternatives. This could include everything from medical supplies to technology services, medical coding, and more.
6. Tap into your referral network. If you’re hoping for a revenue boost in the fourth quarter, consider reaching out to your referral network to help drum up business. The year’s end is a great time for patients to pursue referrals because it’s typically the time right before their health insurance deductibles reset. This means they may only be responsible for a copayment rather than the entire amount.
7. Perform a medical coding audit. If you haven’t already audited a select sample of your claims, now is the time to do it. Look for areas of undercoding and underbilling where you could potentially leave money on the table. It will be important to provide education to physicians, medical coders, and others to ensure revenue integrity in the year ahead.
8. Re-evaluate RCM technology. As you reflect on the year, ask yourself this question: Does our current RCM technology meet all of our financial needs? For example, does it provide essential metrics and benchmarks we can use to improve financial performance? Does it offer transparency into the status of your accounts receivable? What about helping you identify and manage payer rules and updates to federally-mandated transaction standards? Or reduce claim denials by pre-screening for billing and coding errors? If your answer to some or all of these questions is ‘no,’ now might be a good time to explore other options.
Conclusion
The year’s end is a time of reflection, and it can also be a time to move in a new direction. There are many steps your medical practice can take to ensure a strong financial finish in 2022 to set you up for success in 2023 and beyond. Learn how edgeMED can help and be sure to check the Healthy Snacks Blog for more expert insights, best practices and industry trends.
