What steps can you take to improve your practice? Five key areas you can focus on are reimbursement systems, billing and collections, accounts receivable management, operations improvement, and practice growth. Following are key questions you should answer regarding each of these areas.
Reimbursement Systems
Accountant
· Are you maximizing all reimbursements? If not, why not?
· Are optimum codes being used?
· Are the fees being charged correct and are they maximized? One worthwhile exercise to check coding accuracy is to perform periodic reviews of visits to make sure they are coded correctly. Another worthwhile activity is to periodically reeducate those in the office responsible for coding and also to review coding inaccuracies by coder to determine where additional training is required.
· How many coding errors are taking place and what can be done to improve coding accuracy
Billing and Collections
· How effectively are denied claims followed up on?
· What percent of claims initially denied are accepted and what can be done to improve this denial recapture?
· How effectively does your office perform insurance verification and eligibility checks?
· Do you have a good report of co payment collections to make sure that all co payments are collected?
· Are claims submitted and validated electronically?
· How effective is your re-billing procedure?
· How effectively are you collecting for self-pay accounts?
Accounts Receivable Management
· How effective is your collection agency in recovering amounts?
· What percent of receivables are written off? Are write-offs coded by reason?
· Do you regularly receive and review an aged accounts receivable report?
· Do you receive a report of receivables sorted by insurance company to flag any insurance companies that appear to be contributing a disproportionate share of old receivables?
· Have you considered using small claims court to pursue old large balance receivables?
Operations Improvement
· When was the last time you conducted or had someone conduct a review of your policies and procedures to determine if they can be updated or improved?
· To what extent have you considered outsourcing?
· Do you regularly review practice expenses by category to make sure that all costs are adequately managed and controlled?
· Have you reviewed how patients are processed and how they flow through your office to determine if this could be improved?
· How do your staffing costs compare to other practices that are similar to yours?
· Do you have and do you regularly review on a weekly and monthly basis key performance measures for your practice?
Practice Growth
· Do you have an effective way to track which new patients come from referrals?
· What percent of your new patient enrollments is created from referrals? What steps can you take to improve this percent?
· If you advertise your practice, how do you track the effectiveness of that advertising?
All of these areas can be improved by using effective practice management and billing software. In evaluating any new software for your business, you should consider these questions and how the software will assist you in improving reimbursement, billing and collections, accounts receivable management, operations, and practice growth.
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