Tips for Better Revenue Cycle Management in a Medical Office

Posted by Practice Management Institute on May 12, 2021 6:44:51 PM
Practice Management Institute

How would you characterize the success of your medical office? Is it a steady flow of patients, low denials, providers that take an active role in the business, a great clinical and administrative team? How about the financial health of the practice? It’s hard to guide the ship in the right direction when you are too busy plugging holes in the galley.

Managing a busy medical practice can feel like playing a game of “Whack-a-Mole.” There are always new issues popping up that require your attention. The upside is that it is never dull, and if you enjoy problem-solving and taking an active role in the medical office's success, it can be a highly rewarding profession.

The pandemic has challenged the survival of all types of industries, including healthcare. Many traditional medical practices have had to reconfigure the patient care model, investing in technology to implement or expand telehealth services just to stay afloat. Medical offices have suffered substantial losses due to patients that are not keeping up with their care. What’s more, insurance companies are pushing more financial responsibility to insured patients who can’t afford to take on higher premiums and copays, adding more financial strain and risk.

It’s hard to guide the ship in the right direction when you are busy plugging holes in the galley. This is not the workplace culture you want. Healthcare consultant Maxine Collins says it's still possible to improve your revenue cycle.

Revenue Cycle Management generally means getting properly reimbursed for the quality of care and services rendered to your patients. Physicians and providers are interested in improving the bottom line.

Managing patient responsibility, and establishing effective financial policies and procedures are critical for a healthy revenue cycle, says Practice Management Instructor and Consultant Maxine Collins. Her quest is always to help providers and their teams bring in all the reimbursement rightfully due!

"Take a look at fiscal fluctuations from the first three quarters and identify areas where can have the most impact on revenue cycle improvement to finish the year strong." This information will help you make good financial management decisions. 

When you start to dig into the reports, you may find obvious discrepancies like inaccurate insurance data collection and reporting are slowing the reimbursement process. Adapting processes to improve workflow and maximize efficiency will minimize expense. All these are essential pieces of a healthy revenue cycle.

Seek out answers to questions like how can you communicate more effectively with your carriers? Are there any opportunities to get some of their guidelines changed? If so, how? What tracking tools should you use to manage and respond to denials and/or underpayments?

“You can also look for opportunities to offset losses with new revenue streams, like taking on new ancillary services," she says.

Maxine asserts that medical office managers should leave no stone unturned when it comes to enhancing revenue. This includes educating your providers on coding changes, monitoring and updating fee schedules, managing patient responsibility, and establishing effective financial policies and procedures.

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Topics: Practice management, Practice cash flow, medical practice issues, financial management, patient billing, patient collections

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