To say healthcare billing is evolving is an almost laughable understatement to those tasked with managing a small practice's revenue stream. The intersection of new regulations, reforms, and the advent of ICD-10 coding system have left some practices writhing in near chaos to keep their revenue cycle management as strong as it has been in previous years. While Practice Management software, ERA enhanced eClaims, and other tech tools help providers, billers, and payers interact more efficiently, optimizing reimbursement in this unique financial landscape falls to a few often overlooked key areas. 

Invest in Staff or Billing Services

Understanding the revenue cycle management processes has never been more complicated. Staff will need access to continuing education and training on patient education, data entry, payer rules, workflow tools, flags for any processing issues, and much more. Staff will also need continual education and investment each year for the foreseeable future.

Many practices are turning to billing services like MacPractice Business Services because hiring professional help with their revenue cycle management actually saves them money over hiring an additional employee. In addition to direct help with revenue cycle management, MacPractice also provides ongoing training and mentorship to current staff, so that your current employees are enriched and improved by working with a team of billing and software experts.

Focus on Good Patient Communication

Actually getting paid is key to healthy revenue cycle management. Train staff to focus on early patient education so that patients are rarely, if ever, surprised by a bill. Staff needs to be trained to help estimate the costs of care so that they can prepare patients for their bills. Some patients may even request cost information before agreeing to services. Transparency in charges improves patient communication on financial matters, and is an important part of revenue cycle management that avoids debt collection.

Where payment fails, good communication is still key in the debt collection process. MacPractice partners with Transworld to provide integrated collection services you can manage directly in the MacPractice software, streamlined with your usual billing procedures. Transworld redefines the collection agency with a success rate 4 times the industry average and has collected $6 billion over the past decade.

Use Automated Services

Whether that denial is based upon a particular code, particular specialties, or particular accounts, monitoring to track the health of your revenue cycle is so important. ERAs can save hours of employee time every day and provides 100% accuracy in posting. An ERA is the electronic version of a paper Explanation of Benefits (EOB). The payer’s ERA is automatically downloaded for you. The MacPractice ERA Manager associates each payment to a corresponding claim in your software and permits personnel to simply approve the payment for auto-posting.

Review Processes Regularly 

Revisit your daily processes regularly to see that they are optimal. It is much easier to improve revenue cycle management by regularly updating your process than it is to complete a total overhaul. For example, if denial rates are high, find the cause and a solution before the revenue cycle takes avoidable damage.