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5 steps to accelerating cash flow

By Jeff Wood
November 21, 2014
Body of Knowledge Domain(s): Financial Management

Ensuring timely payment in medical groups is a constant challenge. Payer reimbursement policies are continuously changing, which makes it difficult to stay on top of the latest rules and guidelines. Add in the complexity of collecting larger copays and deductibles from patients and even the most efficient practices will find it tough to capture revenue promptly and cost-effectively.  

By streamlining and enhancing revenue cycle processes, providers can improve the accuracy of submitted claims, capture more preservice payments and accelerate cash flow. Practices that have employed the following strategies have reduced accounts receivable (A/R) days and increased payment speed from patients and payers:  

1. Submit cleaner claims. It takes more time to research, correct and submit a rejected or a denied claim than it does to submit it correctly the first time. Automated eligibility verification and claims scrubbers help ensure prompt, accurate payment. Staff training is also critical to generate and submit clean claims. Patient demographic and insurance information that is not correctly captured during preregistration or check-in leads to downstream errors and denials. Ensure that front-office staff verifies the accuracy of information, such as asking for changes to a patient’s insurance, and that coders assign the correct codes by providing up-to-date online coding resources for the latest changes and updates. If a claims scrubber identifies potential errors, dashboards and work lists can help staff correct claims before they reach a payer. When Drs. May-Grant Associates, a Lancaster, Pa.-based practice with 33 providers, reassessed its claims in 2010, the practice streamlined workflow, and an automated claims correction capability helped reduce A/R days by 22% and rejections by 50%. In addition, the practice decreased the time it takes to receive claims payment by 48% and increased its clean claims rate by 11%.

2. Collect payments at the time of service. With increasing copay and deductible amounts, it is increasingly important to collect patient payments at the time of service. Research shows the moment a patient leaves the hospital after a procedure, 50% are less likely to pay the bill.

To increase the odds of collection, provide an estimate of patient financial responsibility during a preservice phone call or at check-in. By verifying insurance coverage and corresponding copayment, coinsurance and deductible amounts, staff can generate a credible estimate, engage patients in financial discussions early in the treatment process, set payment expectations and collect fees or request credit card authorization to cover a balance once reimbursement is received from a payer. At Drs. May-Grant Associates, automated eligibility processes enable staff members to verify patient insurance information before scheduled exams so they can calculate patient fees and collect payments at the time of service.

3. Automate denial management processes. Improving denial rates accelerates payment, reduces collection costs and frees up staff for revenue-generating tasks, say industry members. Automation helps providers research denied claims, streamline workflow and pinpoint the cause of common claim denials, according to professionals at Reading Hospital Medical Group (RHMG), Reading, Pa., who used system data analytics to identify a department that generated a large number of errors, and sent the team for retraining. By holding the individuals accountable for registration and claims submission errors, RHMG reduced its denial rate by 59% during a nine-month period.

4. Offer patient-friendly payment options. As out-of-pocket fees increase, some patients struggle to pay medical bills. Flexible payment options, such as recurring payment plans charged to a debit/credit card on a set date, might increase the likelihood of payment. A Navicure study conducted earlier this year found that almost one-third (32%) of provider organizations never offer patients that option, primarily because 61% of practices don’t estimate patient costs at the time of service.2 By taking advantage of credit card and payment processing solutions, practices can offer patients an option and eliminate the costs of paper statements, phone calls, agency commissions and the risk of debt write-offs. These solutions allow providers to swipe a patient’s credit card and securely store information for future charges. This process, known as “tokenizing,” helps patients distribute large payments across multiple weeks or months. Before each charge, a practice sends a patient an alert or reminder via email or text message with a receipt once the charge is complete. 

5. Leverage financial analytics. With access to the right data, practices can monitor payment processes for completeness, correctness and speed; identify areas for improvement; and prevent bottlenecks. Texas Retina Associates, a 13-office subspecialty ophthalmology practice in the Dallas-Fort Worth area, uses a variety of financial analytics and reports to gain insight into its revenue cycle performance and to combat rejections and denials. The ability to parse this data and analyze it by location, category, provider and dollar value allows the practice to spot trends, uncover potential issues and search for root causes. When one location saw an increase in rejections, the practice traced it to a new staff member who was incorrectly inputting insurance information on certain claims. The provider quickly addressed the issue with training and guidance, averting similar rejections down the road.

The practice also leveraged financial analytics to verify the effectiveness of new processes, identify potential problems with payers and enhance communication with physicians. As a result, the practice experiences fewer errors, which helps increase efficiency, improve productivity and
accelerate payment.

An ongoing pursuit

Whether you are collecting from patients or payers, the ability to identify new and innovative ways to refine revenue cycle management processes can prevent errors and boost productivity. While improving cash flow might seem like an elusive goal, it is possible with the right combination of determination, staff training and technology.

Notes:

2.    Porter Research. 2014 Physician Payment Solution Study.

Jeff Wood, vice president, product management, Navicure

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