Defective revenue cycles are like faulty fuel lines in your car. They leak the juice that keeps your practice running properly. Without a healthy stream of revenue coming in, your practice will eventually break down.
Denied claims, underpayments, and patients failing to pay copays are some of the leading causes of revenue cycle inefficiencies, creating a syphon that slowly drains profits from your practice.
As with your car, sometimes it helps to call in a professional for repairs. Reading this should help you plug the leaks and ensure better reimbursements moving forward.
Denied Claims
Reoccurring claim denials by payers create a hidden expense for your practice. According to MGMA, the average claim denial costs practices $25 to $30 each, even if the payment eventually gets approved.
CareCloud Central makes reducing claims denials easy by allowing you to check patients’ insurance eligibility before they even step into the office. Automatic eligibility checks are performed in batches overnight, letting you verify eligibility in advance without doing any extra work.
Another way to reduce denials is making sure your staff submits claims correctly. They may need to slow down, be more careful when filling out forms and double-check their work before submittal.
For a speedier solution, consider subscribing to CareCloud Concierge, our revenue cycle management service. Concierge combines extensive practice management tools with expert medical billing support to make nearly every claim submittal a successful one.
Underpayments
Due to a large number of payer contracts a practice must keep track of, underpayments by insurance providers can go unnoticed for extended periods of time.
It’s essential to review contracts at least twice a year and confirm each payer is reimbursing accordingly. Focus particular attention on the most popular insurance providers.
Also, keep payer contracts organized by using a contract matrix, which lists all of the renewal dates for your current agreements. Many contracts renew automatically, meaning your rates stay locked in. By knowing when contracts expire, you can renegotiate new, more profitable terms.
Patient Failure to Pay Copays
The best time to collect copays is when the patient is in the office because once they leave, the chance of actually receiving payment decreases and the cost of collections increases.
Using communication to your advantage is the key. Before patients leave the office, ask them how they would like to pay their copay that day. Asking how, not if, will enhance the chances of them paying before leaving.
Also, prepare patients for what they can expect to pay out-of-pocket by offering price estimation. Create estimates based on what other patients pay for the same service.
Chances are, if patients have the funds to pay and are prepared ahead of time, it’s likely they’ll come prepared to pay when they visit.
Optimizing revenue cycle management is the key to maintaining a profitable practice. By plugging the leaks in your collections process, you can retrieve the revenue that would have been lost otherwise.
