5 ways to improve practice billing and efficiency

When it comes to practice billing and your overall workflows, it is as important as ever to make your healthcare practice more efficient.

The practice of medicine is changing at an unforeseen pace. With fee-for-service reimbursements declining, practices need to make sure they are maximizing productivity, collecting all they are entitled to, and making the important shift toward value-based care.

So how does a practice know if they are doing their best? How do they identify areas that need improvement?

The regular collection of data allows a healthcare practice to assess whether the correct processes are being performed and if the desired results are being achieved.

If you can't measure it, you can't manage it—and in turn, you cannot make your practice more efficient.

1. Identify missed revenue opportunities to improve practice billing

Keep your schedule full and productive. How many appointment slots are being blocked for lunch, meetings, or personal time? Blocked appointment slots = potential lost revenue. What is your percentage of cancellations and no shows?

Every good EHR will have reports and tools that make it easy to not only review your history and identify opportunities, but also to do something about them. For example:

• Use a wait list to automatically prompt your staff to fill cancelled or newly opened slots with patients who have requested them
• Set up online patient self-scheduling. Better systems allow you to configure your system to allow patients, including new ones, to self-schedule into specific slots that fit your desired visit types by doctor and time
• Remind patients about their appointments. Everyone gets busy but thankfully integrated automated reminder systems are very easy to implement and can be configured to use the patient's preferred communication methods whether text or phone. Rule-driven responses can allow patients to cancel if there is still enough time for you to fill the slot. The patient won't show anyway, and if your tools allow you to contact patients who requested slots or need quality-based follow ups, why not do that? 

What is the value?  Simple, just calculate your average collected revenue per appointment and that's the cost of an empty slot.  Not to mention the intangible value of happy patients who want access to physicians.

2. Improve your first-pass resolution rate

The first-pass resolution rate is the share of a healthcare practice's claims that get paid on the first submission. This is a direct reflection of the practice's revenue cycle management processes.

Are you verifying insurance eligibility? Obtaining required authorizations? Maintaining accurate patient demographics? How many claims are being denied due to coding and billing mistakes?

Here are some quick, practice billing fixes that are easy to deploy:

• Leverage insurance eligibility checking. This is simple to do and can be configured to check upon scheduling or right before the appointment—something that is particularly important early in new year when many patients' plans have changed. They also ensure you're entering complete patient and insurance demographics up front so your claims will go through later. Invest in systems that allow patients to self-register with tools that scan their driver's licenses and insurance cards, so you don't have to enter the information yourself
• Obtain required authorizations. Does your system allow you to flag certain procedures that may be denied and uncompensated for work done? If so, do it and get the appropriate payment agreements, ABNs, and authorizations. Your team can be alerted during scheduling and other system checkpoints
• Use fee schedules to automate tasks that affect the payment of your claims such as notifying you when a procedure requires prior authorization, an ABN, and insurance-specific modifiers
• Leverage claims editing and scrubbing tools. They are sophisticated and can help you fix coding and other issues up front when it's easier to do
• Use retrospective tools to look at your rejections and denials. Your system should have interactive tools that can sort and group, so you can see the issues that have the greatest dollar and unit impact. Become more efficient and put incremental processes and rules in place that may even automate corrections in advance of sending future claims. Focus staff training more easily to drive impactful change.

3. Reduce the age of your AR to improve practice billing

The number of days in accounts receivable (AR) represents the average number of days it takes a practice to get paid. Do you know what to do if your AR is getting older?

When the days-in-AR number is low, that means a practice is obtaining payments quickly on average. Your EHR should offer many reports that monitor this number and identify problems with certain payers or procedure codes so that they can be resolved quickly.

Make sure you have a robust collections module that offers virtually every way to group a list of invoices for follow-up. Can you see claims by payer reason codes to identify denials so that staff can respond quickly? Can you quickly generate a list of claims to appeal and automatically complete the payer-specific appeal documentation and attach copies of the narrative? Can you accomplish what should be simple tasks from one screen such as sorting overdue patient balances with the ability to generate collection letters or make phone calls?

Most critically, you should be able to automate and assign routine follow-up activities such as the examples above and more. When done right, your healthcare practice can create these worklists automatically and have them forwarded to the appropriate staff while allowing administrators the ability to monitor these tasks. Your staff will ensure they don't fall through the cracks, piling up to become a mountain of practice billing work that is often too late to collect on.

4. Improve efficiency by delegating work outside the exam room

Having a patient complete as much of their own administrative and clinical intake can make you efficient and even help you see more patients without sacrificing quality.

Your system should allow for online- or kiosk-driven completion of consents and waivers that are stored in the patient's files. You should also have tools that make it possible for patients to review and update clinical information such as problems, allergies, and current medications in addition to a history for their current visit.

Save your team time so they are just reviewing and updating instead of being data entry clerks.

5. Drive efficiency by reducing practice re-work

The single most effective way to improve patient care and satisfaction, reduce costs, and increase physician income in a medical practice is to drive down the percentage of re-work. Behavior changes when a person recognizes the need for change.

Help your team understand the cost of mistakes in a professional manner.  Show them critical data and trends using reports such as practice summaries of appointments, claims, payments, and more. Help them better understand your business. Give them adequate training time and materials so they know your systems. Engage with your vendors' training options such as online forums, tips and tricks, training videos, and even attend conferences or user group meetings.

Allow staff to correct their own mistakes. Create a strong, positive coaching environment for your practice, and staff will learn from their mistakes and not make as many in the future. This is a recipe for success when it comes to improving your practice billing and making your practice more efficient.