From Patient Visit to Payment: It's All about Teamwork.


The top priority at your practice, of course, is taking care of patients—doing whatever you can to help them get well and stay healthy.

Your practice’s financial health is nearly as important, but can be much more difficult to manage. You want to be around to take care of patients 10, 15, 20 years into the future—and that means you must have a strong foundation. Optimizing revenue, managing your cash flow and keeping a close eye on costs are key to success for any practice. It’s a challenging task—and one that requires an “all-hands-on-deck” approach.

Let’s start with the reception desk staff. The team that greets and registers patients are the “front line” in more ways than one. Not only are their shining faces the first ones patients interact with, they represent the first opportunity to collect payment. Front desk staff members verify coverage, insurance and demographic information—all of which support fair and timely payment. In addition, they make sure co-pays, deductibles and balances are collected. It’s not an easy job—patients may be ill or worried, and are often accustomed to paying only after they receive a bill stamped FINAL—but it’s nevertheless an important one.

Asking a patient for money is not always easy—and can even seem poorly timed when that patient is not feeling well. However, it’s in the best interest of the practice to train the reception desk team so they are comfortable explaining the amount due, and understand how to handle patients who may be resistant or reluctant to pay at the time of service. Healthcare has allowed patients to pay after the fact for years—and is virtually the only industry that does. Can you imagine your server at a restaurant letting you walk out of the door and allowing you to pay for your meal weeks later?

Don’t forget how important general customer service training is, too. Patients who are greeted warmly and with respect, who aren’t kept waiting, and who are made to feel like they are important to the practice will be inclined to pay their bills willingly and quickly. That translates to money in the bank.

Clinicians. All of those involved in the patient’s well being—whether physician, nurse or medical assistant—determine the type and level of charges that can be billed. They must understand how to record and document the visit with the patient to ensure all charges are captured. Historically, American Medical Association and Medicare data indicate that physicians tend to under-code, leaving money on the table and shortchanging their practices of income rightfully earned. Using an electronic health record system can guide clinicians through documentation so they don’t overlook or dismiss services and procedures that represent revenue. In addition to technology, practices can improve charge capture by making sure clinicians are kept up to date on constantly changing documentation requirements so they are aware of revenue potential and pitfalls.

Coding staff. These important team members are the linchpin in transforming care to cash. Practices with the strongest revenue stream rely upon coders who are credentialed, demonstrating a solid understanding of their practice’s medical specialty as well as ever-changing coding policies. They should have access to current information, such as ICD-9 (and soon, the much anticipated and dreaded, ICD-10 code set!), CPT, HCPCS and CCI edits resources. Professional training at workshops, webinars and conferences such as those offered by the American Academy of Professional Coding is invaluable. The most successful practices also conduct periodic audits of their coding practices. This allows leadership the practice to identify episodic or ongoing errors, evaluate clinician documentation effectiveness and even measure productivity.

Billing staff. Tasked with making sure claims are submitted and patient statements are generated, billers must keep track of thousands of pieces of information. Lose track, and the practice potentially loses money. Advanced technologies assist these professionals and streamline the critical process of getting paid. The Emdeon Office Suite, for instance, enables practices to create claims online or upload them directly and seamlessly from the practice management system. Claims management features help practices scrub claims prior to submission to reduce rejections. The software can also generate statements and expand patient options, by offering online payments or credit card processing.

This level of automation delivers great value. Fewer coders and billers are needed to prepare and submit claims, freeing them to pay closer attention to outstanding payments and overdue balances. They can also monitor payer compliance with contracts and fee schedules, further stabilizing the revenue, and ultimately the practice.

Management and leadership. Last but not least is your management team. They set the stage for a financially stable environment. They hire capable staff to assume responsibility for various administrative and operational tasks. They communicate the need to support exemplary care giving with smart business practices. They identify new opportunities—like meeting Meaningful Use criteria—and implement the tools necessary for success. And they provide robust training and technology to make sure the bottom line is as healthy as you want your patients to be.

Do you have a winning team? Take some time to make sure each player has the right training and equipment to do the job. If you find opportunities for improvement, take a look at how Emdeon professional services can help.

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