In the past few years, there has been a series of unprecedented drops in the revenue of medical practices. Healthcare providers are struggling to ensure that revenue streams remain constant and pinpoint revenue leakage in the healthcare field. Consider the top causes an office of medicine suffers a drop in revenues, and then the ways to prevent the loss.
The Reasons Why Your Medical billing Practice is losing money
Claim Rejection or Deny Management
An essential aspect of managing the finances of medical practice is to reduce rejections of billing claims to the maximum extent possible. As high as 10%of Medical claims get rejected every year, but the majority of denied claims could be avoided. Be sure to track all claims filed and ensure that your administrative staff is aware of how to avoid rejections of claims by using proper initial inputs and dealing with rejection in the event of a rejection. One unpaid claim might seem small initially, but in the long run, denied claims can result in a massive loss.
Tips for reducing medical billing errors
● Make sure that the information for patients is accurate. Verify that names, policy numbers, birth dates, and any other pertinent details on the bill are correct and up-to-date.
● Utilize technology
● Inform the clinical staff
● Be aware of changes that are likely to be happening
There are too many no-shows.
Missed appointments cost healthcare providers around $150 billion per year. The cost of an absence from the healthcare provider is around $200. So, ensuring you don’t miss appointments is crucial to avoid loss of revenue in the healthcare field. Be sure to put automated systems set up for patient reminders. This could include automated text messages or phone calls. Make clear the rules regarding missed appointments, too.
Inaccurate Medical Coding Practices for Medical Coding
Clear coding of claim submissions can reduce the chance of rejection at the beginning and helps keep the profit margin for medical billing within a certain range. The incorrect coding of elective services, medical supplies in treatment, or bundle services can hurt the practice a lot. In one study, an individual practice was able to make code errors in more than 70% of the claims, costing the practice more than $185,000 over the span of a single year.
What are the medical credentialing services?
Medical credentialing confirms that physicians and nurses are appropriately educated and certified and possess the necessary professional experience to offer medical treatments to patients. It’s an essential aspect of keeping high-security standards in the healthcare profession.
Correct and timely health insurance certification is vital for practitioners to be reimbursed by insurance firms. It’s a hassle, lengthy and can result in hundreds of thousands in loss of earnings. If you do it incorrectly, to get it to understand, look at the following error in Medical Insurance Credentialing.
● What kinds of medical professionals must be certified?
● Credentialing is the same as the signing up process with an organization, like a clearinghouse.
● What’s the problem with the process of obtaining credentials?
● What are the deadlines for obtaining credentialing?
● Do you know of other methods companies lose money due to mistakes in credentialing?
● How do most practices manage credentials?
● Why are outsourcing tasks for credentialing better than performing them in-house with customized software?
● What areas of expertise require the most effort for accreditation?
Loss of Productivity
One loss in fee-per-service daily could result in up to 15,000 dollars of annual income loss in healthcare. The reality is that most practices receive less than the ideal amount of patients because of a lack of productivity. The reason for this can be:
- The provider is not providing the services that customers would want from the service.
- Primary care doctors and physicians have much time to complete administration and paperwork.
- Not using the right technology not using the right technologies, for example, the reliable EHR or an automated telephone system to manage calls
- Overbooking or underbooking patients
- Too much time spent with patients due to complicated services or a lack of knowledge of the patient’s needs
Excessive Time and Staffing Overload
Overtime due to inadequate staffing rapidly adds up. Remember, in the case of paying time and a half per hour, it’s more affordable to pay the standard hourly rate for the same amount. Hiring new employees could be more cost-effective if the company needs employees to work more than 40 hours per week. Overstaffing can be equally expensive. For instance, when everyone is working simultaneously, but there isn’t a single person with something to accomplish, the procedure is to pay the additional employees with no value.
Simple Theft and embezzlement
The Theft of small amounts of practice equipment is a major source of revenue for medical billing practices but is usually neglected. It doesn’t matter if it’s administrative equipment like sheets of paper, markers and boxes filled with pens or even practice equipment such as gauze, gloves, and syringes. This kind of Theft accumulates throughout a calendar year. It could result in hundreds of dollars of loss in profit. The risk of embezzlement can be minimized by conducting regular inventory checks and ensuring that you monitor and vet employees who are practicing.
Incorrectly updated Fee Schedules
Fee schedules need to be reviewed and revised regularly to ensure that they are in line with RBRVS (resource-based relative value scale) set in the Centers for Medicare and Medicaid Services. A fee too low could quickly reduce the profits of medical practices. For instance, if the practice charges at least $10 less than the RBRVS rate for an in-office screening, that could translate into thousands of dollars lost in the long run.
Methods to Stop the leakage of revenue in healthcare
Improve Methods for Collection make sure you have a foolproof practice collection system that is completely foolproof. Check that your practice’s revenue cycle aligns with billing hours for service. The longer a request sits in limbo or a bill is not paid by patients who pay cash; as a result, the more money the practice will lose because of cash flow issues. Be sure that your practice has a clearly defined strategy regarding collection and billing. Ensure you follow the most current coding guidelines and set clear rules regarding patient payments that patients can understand before they receive services.
1.Help patients in Urgent Care.
Urgent care clinics are accessible across the nation. Additionally, many patients go to one of these clinics instead of their regular doctor due to quicker access to medical billing and lower prices. Suppose your practice experiences losses in revenue because of the number of patients visiting the urgent care clinic, and you want to keep them; keeping an eye on your urgent patient appointments is crucial. It could mean altering practice hours to accommodate requests for urgent appointments, bringing on more staff, or even implementing telemedicine to ensure that patients continue to visit the clinic.
2.Modify the Marketing Strategies of Your Business
If your medical practice’s revenue is declining because of a lack of patients, your marketing plan might require a change. Take a look at the following:
- Your social media accounts and how they’re doing or the messages you send to customers
- Printing marketing materials distributed in the office or via mail
- General online reputation, negative press, patient reviews and negative feedback
- Newsletters, emails along with direct strategies for marketing
Three out of five patients prefer providers because of a positive online presence.
3.Consider Monetizing After Hours
If you are looking at ways for doctors to earn extra cash, usually the most effective place to begin is to determine the hours available. Inviting patients to visit after normal appointment hours increases the chance of earning new income. Instead of using an emergency room within the area to seek advice or treatment, patients would rather see their physicians. Still, many doctors are not available after a specific time of day. Making money after hours could mean opening a practice late on weekdays, offering half-days at weekends, or providing remote medical appointments even when the office is closed.
Things to Take Away from PrognoCIS
While medical practices’ income will be unpredictable, many factors impacting revenue can be controlled more tightly for more effective results. When your clinic is struggling with revenue leakage, looking at everything from staffing practices to billing could be an appropriate step. Even something as basic as an inefficient EHR system could change the entire picture of the downstream revenue of healthcare. Are you ready to discuss a complete EHR option for your business? Set up a live demonstration using PrognoCIS.