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Using analytics to automate and streamline your medical practice’s revenue cycle

Insight Article - December 3, 2019

Billing & Collections


Business Operations Technology

MGMA Staff Members
Manual data processing in your revenue cycle is an area prone to things going wrong. From something improperly keyed to the difficulty of maintaining dozens of spreadsheets, there’s ample opportunity for error.

When it comes to smaller medical practices, those minor errors become compounded when billing staff — as any employees might — take vacations, call in sick and otherwise cause the work to pile up.

Finding the right degree of automation was crucial for Andrea Vitalich, clinic administrator, Pacific Rim Orthopaedic Surgeons, PLLC, in digging out from that situation where “everybody is trying to help everybody keep up” in a practice with limited resources and high staff turnover in the billing department, she says.

One of the reasons that building a streamlined workflow was able to help Pacific Rim Orthopaedic Surgeons is because the data elements were easily reportable to track days in A/R, where an individual claim was in the process and when the last time a claim was worked.

That new approach that the practice sought out is “essentially what all of my mentors have ever taught me,” Vitalich says: “If it’s not documented, it doesn’t exist. So our goal is to essentially have everything documented.”

In her session co-presented with Matt Seefeld, executive vice president, MedEvolve, at MGMA20 | The Financial Conference, the intent is to walk through that streamlining process and identify administrative pain points that impact a practice’s bottom line, as well as recognize where opportunities exist to improve billing, collections and claims.

While the promise of automation sounds good, Vitalich says that it’s just like any other initiative in a medical practice setting that begins with winning buy-in from physicians who may not understand those pain points for staff members.

“Part of my role was simply educating [our doctors] that healthcare is no longer what it was 30 years ago,” Vitalich says of physicians that only want to boil things down to increasing revenue and decreasing overhead without taking a renewed look at the hurdles on the revenue cycle side. “You’re never going to be reimbursed the way you were 25, 30 years ago.”

Educating on how payment has shifted in healthcare in recent years is a crucial first step to outlining a plan for improving processes and seeking out solutions to automate manual work.

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