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Best Practices
Coping with Reform: Renewed focus on revenue cycle management Print E-mail
Written by Barry Walters   
Monday, 05 July 2010 16:05

Payment errors cost U.S. medical groups billions of dollars annually.  A $2,000,000 practice typically loses $100,000-140,000 a year on claims paid at less than the contract rate.  This problem can be broking down into 5 key points:

*         Billing and collections consumes 5% to 8% of practice revenue    

*         Heightened scrutiny by payors of all claims leading to an increase in the number of denied claims

*         Increase in the complexity of billing rules. 

*         The number of provider plans is increasing.

*         Change in federal and state legislation have increased the administrative burden on physician practices.

Practice management systems alone cannot correct this because they are not designed to identify or track contractual payment errors.  Solving this problem requires a practice-specific payor contract knowledge base which can value the services performed according to the complex terms of today's healthcare contracts.  The solution is a physician revenue cycle management that encompasses a unique integrated solution which includes web-based practice management software, claim submission, electronic eligibility verification, payment posting, claim follow-up, denial management, insurance rule creation, insurance contract definition, appointment reminder calls and more.  All designed together to increase a practices revenue and meet challenges of a vastly complex medical practice landscape.

With the impact of the historic legislation to overhaul our nation's health system many questions concerning its potential implications for the physician community are arising.  Most of these concerns are around Insurance billing and patient management.  Practices need to have the foresight to set up an all inclusive revenue cycle management system that will probe the key concern of billable dollars and give them the ability to get paid what they deserve from the insurance companies.  Acting on this with give doctors the ability to understand the health of their practice at anytime and allow them the time to focus on the practice of healthcare and not the business of healthcare

Contact the Author

(786) 255-3192  

http://www.mdeverywhere.com

Last Updated on Thursday, 23 December 2010 06:55
 
Ensuring Patient Compliance with Imaging Orders Print E-mail
Written by Jeffrey Herschler   
Tuesday, 23 March 2010 09:38

It’s no secret. Results from Diagnostic Imaging are a fundamental part of a patient’s health record. Essential to patient care and risk management, including Radiologist’s reports in a chart is good business for primary care and specialists alike. Here are five rules to assuring Patient Compliance with Imaging Orders:

  • Schedule the appointment for the patient; give him/her an appointment card
  • Initiate the Authorization Process and advise patient of projected out-of-pocket costs
  • Make sure the patient is clear on the IDTF’s location; if the IDTF offers free transportation, let the patient know
  • Advise the patient of the IDTF’s credentials; your patient trusts you and will now have added confidence in your recommendation
  • Let the patient know what the follow-up will be following the test; remind the patient that a complete diagnosis is essential to implementation of an effective treatment plan

Following these simple rules will result in improved patient compliance, reduced risk and better patient care. These outcomes are consistent with Best Practices. Providers who embrace Best Practices consistently outperform their peers in growth and profitability. It’s that simple.

Last Updated on Saturday, 26 June 2010 14:27
 
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