The 2022 edition of the Medical Group Management Association's MGMA DataDive Cost and Revenue Report indicates the pandemic has sparked an overall downturn in healthcare productivity, increased operating costs, staffing shortages, and inflation. One positive shift noted was an increase in patient portal use. There's a lot of ground to gain in 2023. Seeking out efficiencies has never been more important.
Managing the Practice
Practice managers have their work cut out for them in 2023, working to 'right the ship' and get the financial indicators back on track. Certified Medical Office Managers (CMOM) understand how to seek out cost efficiencies and reduce claim denials to improve revenue. They analyze complex business processes that drive the medical practice revenue, and lead the charge to help curb financial and operational struggles. These challenges are always in a CMOMs view, no matter the economic climate.
With changing regulations and standards and numerous risk factors in the medical practice, CMOMs learn how to mitigate compliance errors and avoid litigation issues to truly protect the practice. They become versed in employee law, risk management, HIPAA, Medicare, and OSHA compliance.
Knowing how to overcome staff shortages and “The Great Resignation.” CMOMs learn how to recruit and retain a talented workforce, and most importantly, how to build an engaged team that focuses on patient care. Along with strategies for recruiting and onboarding, CMOMs also learn about managing employee performance, motivating employees, and improving absenteeism
CMOMs learn effective time management for both their staff and providers alike. Knowing how to manage areas with the biggest bottlenecks such as scheduling, patient check-in, insurance verification, etc., can help keep operations in check, errors reduced, and patient satisfaction high.
Revenue & Cost Strategies
Financial management is among the most challenging and rewarding skills that CMOMs gain in their training. Advocating for their providers and seeking out ancillary revenue opportunities are among the most valuable skills they gain from their training.
These skills are critical for forecasting revenue, maintaining the budget, managing payables, and ensuring that revenue projections hit the mark. And in a rapidly changing healthcare landscape, it's best to keep your knowledge and skills up-to-date!
"Make time to review your payer contracts and negotiate higher reimbursement," PMI faculty member and CMOM instructor Linda D'Spain says.
"Managers who master the revenue cycle can achieve higher claims payment approval rates, faster receipt of claims payment, reduction in claims denials, and improvement in the overall financial health of a healthcare organization."
"Those, directly and indirectly, responsible for a successful revenue cycle must stay educated so they can lead their teams to success."
Major areas of aptitude participants gain in the CMOM course include:
- Knowledge of various types of health insurance plans
- Expertise in effective claim follow-up, patient follow-up, and denial resolution
- Full-circle look at the progression from patient registration through receipt of payments
- Aptitude for the processes of credentialing, coding, payment posting, denial oversight, and regulatory guidelines
- Skill development in technology use, internal audits, value-based payment models, and analytical reporting
CMOM-certified medical office managers understand how to tackle staffing issues, regulatory updates, and revenue. Their expertise in practice management includes proficiency in the areas of personnel, financial management, and the managed care delivery system, Under a CMOMs watch, physicians can sleep through the night. They are relied upon core revenue drivers, seek out efficiencies and ensure that practice staff is performing optimally in their roles.