Sep 4, 2022 | MedCycle Solutions, Partner
Collections aren’t the most glamorous part of running a practice. Perhaps the only thing worse than making collections calls is receiving them! Unfortunately, collections are necessary and if done correctly, it will allow you to collect on accounts that have sat stagnant for months, sometimes years.
In our years of experience managing collections for small and medium physician practices, we’ve identified seven best practices for optimizing your collections.
- Speak their language. There are so many ways to communicate these days. Routinely ask and record how your patients prefer to be contacted. Phone? Email? Text? Mail? Patient Portal? For best collections results, communicate with your patients using their preferred communication method.
- Allow multiple payment options. Similar to communication methods, there are several payment methods that different people prefer. For some, a payment plan might be their best option. For others, credit card payments. For yet others, cash or checks. Sometimes, patients want the ability to finance their medical procedures through a healthcare financing company like Care Credit. And with today’s ever-changing technology, look into text message billing reminders with links to pay from their phone – and even QR code-driven options! Make sure your practice can accept multiple forms of payment to optimize your collections.
- Coach your staff. We encourage you to train your patient-facing staff to implement some basic key principles: Be a good listener; Talk in terms of the other person’s interest; Make the other person feel important and do it sincerely. By implementing these simple practices, your patients will feel less attacked and more heard – which in turn will hopefully lead to increased payments.
- Optimize technology. Most practice management systems, patient portals, and/or EHR platforms have advanced notification settings where you’re able to reach out to the patient (via their preferred communication method, of course) with reminders, balances, past-due alerts, etc. Using technology to automate parts of the process can reduce the heavy lifting for your staff.
- Discuss costs upfront. Being upfront about the costs of your patient’s care is one of the most effective ways to minimize collections. If you offer a limited number of services, consider listing the prices on your website or marketing collateral. If you’re a general practice, ensure your staff is communicating with patients before treatment regarding costs and how they plan on paying for their care. A shift we’ve seen over the past several years in healthcare is having a Patient Financial Counselor on the front end. This roles’ primary responsibility is to know what the patient is coming in for, verifying their benefits & coverage – and then reaching out to the patient before the appointment to provide them with an out-of-pocket estimate and payment options. That way, when the patient presents for the appointment, they are already aware of their financial obligations, and not surprised a few months later with a bill they were not expecting.
- Incentivize your collections staff. Collections can be tedious and tiresome. Consider offering incentives to help the task feel a little more exciting – small prizes can go a long way in motivating! Some incentives we’ve seen include PTO, cash, practice logo wear , and gift cards – based on the amount they’ve collected.
- Enlist expert help. Consider partnering with a healthcare-focused organization that specializes in collections. The tricks they’ve learned by working with other practices may decrease your outstanding balances in a shorter amount of time than doing so internally.
Implementing these tips can help reduce your collections timeline and increase the amount you’re collecting.
There are many great organizations that can help you in these areas – and MedCycle Solutions is one of them. If you’re wondering how partnering in these areas could work for your practice, let’s connect. Ranadene (Randi) Tapio, MBA, CMRS, CPCS is the Founder & CEO MedCycle Solutions, which provides Revenue Cycle Management, Credentialing, Outsourced Coding, and Consulting Services to a number of healthcare providers in a variety of specialties. To find out more about MedCycle Solutions services please visit www.MedCycleSolutions.com. You can reach Randi via email at Randi@MedCycleSolutions.com or call 320-290-6448.
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Aug 15, 2022 | MedCycle Solutions, Partner
By Ann Knutson, CPC-A
The healthcare revenue cycle includes all administrative and clinical functions that involve capturing, managing, and collecting the provider’s/facilities revenue. The cycle includes three distinct parts of the practice/facility that’s referred to as the front-end, middle, and back end. Unfortunately, most of the time there is little coordination between the three areas which can lead to more claim denials and lost revenue for the practice/facility. Therefore, adding a revenue integrity team to your practice/facility dramatically improves operational efficiency, compliance measures, and reimbursement rates. Members of the team must have extensive knowledge of and be familiar with the complete healthcare revenue cycle.
In order to foster collaboration between all three areas of a practice/facility that affect the revenue cycle, specific training needs to be implemented for staff, along with coding and documentation education for providers.
Specific staff training includes:
- Keeping up to date on billing requirements, such as coding guidelines, billing regulations, and insurance payer policies.
- Reimbursement updates, such as data showing rate of reimbursement vs. denials/rejections.
- Key performance indicators, such as data regarding common billing or coding errors leading to claim denials and rejections.
- Job expectations, such as all billing employees must know every aspect and function of their job in detail.
Provider education involves:
- Chart reviews to verify proper documentation.
- Quarterly meetings regarding coding guidelines, payer rules, and the importance of medical necessity.
Furthermore, creating templates and tip sheets for billers, coders, and providers improves operational efficiencies, clean claim submission, and proper provider documentation. It also decreases claim denials and puts everyone in the practice/facility on the same page.
In addition, the collaboration between coders and the accounts receivable team is crucial to improving reimbursement rates, the outcome of claim appeals, and compliance with regulations. It can also help to reduce the number of claim denials and rejections. Plus, medical coders are able to share their expertise regarding regulations and proper coding with the Accounts Receivable (AR) team members. This helps the AR team with reconciling claim rejections and denials along with properly submitting appeals. On the other hand, the AR team can inform coders of the current codes or coding combinations that are being rejected or denied by payers. With this vital information, coders can make the required coding and billing changes as they enter the charges and submit the claims. This can greatly improve the rate of clean claims submission. (AAPC, 2021)
Therefore, it’s in the best interest of a practice/facility to implement a revenue cycle management team that is familiar with the entire revenue cycle, fosters collaboration between all areas of the practice/facility and providers, and maintains open communication between all departments in order to maximize revenue cycle efficiency and reimbursement. For assistance with maximizing your revenue cycle efficiency, please contact us at MedCycle Solutions.
For more information about maximizing revenue cycle efficiency, please visit www.aapc.com.
Ann Knutson, CPC-A is an Accounts Receivable Specialist at MedCycle Solutions, which provides Revenue Cycle Management, Credentialing, Outsourced Coding, and Consulting Services to a number of healthcare providers in a variety of specialties. To find out more about MedCycle Solutions services please visit www.MedCycleSolutions.com.
Jul 12, 2022 | MedCycle Solutions, Partner
Have you increased the amount of Telehealth visits with your patients?
If not, you and your patients may be missing out.
Over the past two years, the COVID-19 pandemic has changed the landscape of patient care and increased the need for providers to utilize virtual healthcare services. Due to the Public Health Emergency (PHE) policy update, many healthcare practices had to shut down, pause or augment their services with telemedicine to provide flexibility in patient support.
Here are four ways Telehealthcare has been implemented to provide safe, necessary care for patients while augmenting revenue.
- Stop the Spread of Contagions
With the need to quarantine, social distance, and reduce the risk for clinic staff and patients, many health practices adapted ways of providing non-emergency services. For patients with (possible) highly contagious diseases, such as COVID-19, many clinics ask patients to schedule virtual appointments to avoid possible infections and further outbreaks. This allows for keeping both the staff and patients as safe as possible while still receiving necessary treatment.
- Provide Essential Health Services
For those patients that suffer from White Coat Syndrome going to the doctor’s office causes a great deal of stress and anxiety. By allowing patients to access care in the comfort of their own home for managing chronic health conditions, routine services, prescriptions, and referrals for testing and labs, this allows for greater patient access. Plus, it has the added benefit of reduced overhead costs associated with cleaning and turning exam rooms.
- Provide Physical and Occupational Therapy Healthcare
Accidents happen. Whether motor vehicle accidents, workplace injuries, or trips and falls – PT and OT is imperative to keep patients mobile and progressing. Many providers offer hybrid services with virtual appointments for patients to keep them mobile while supervising and adapting exercises in their home environments.
- Provide Mental and Behavioral Healthcare
Mental and behavioral healthcare is one of many patient-care needs. This is especially true for long-term residential care. Many nursing home facilities transitioned to telemedicine during the COVID-19 pandemic.
The U.S. Department of Health and Human Services, via the Centers for Medicare & Medicaid Services (CMS) heavily promoted the switch to Telehealth as infection prevention and control measures. They’ve made digital resources available that offer behavioral health and best practice guides for long-term nursing homes, a telemedicine tool kit, as well as other guidance.
If you think your practice and patients can benefit from implementing telehealth visits stay tuned for our next article on 5 Resources for Implementing Telehealth & Telemedicine.
Mariellen Mezzacappa has a variety of experience in the medical field. She has worked for doctors, hospitals, pharmacies, and insurance companies. Her experience includes bill review and coding with a wide range from EAPG 3M, DRG, Workers Compensation to Appeals and coder Affidavits for Litigation. She provides verification of code selection for operation reports, documentation review, and credentialing. Additionally, she has worked on operation policies, compliance training, and project management.
MedCycle Solutions provides Revenue Cycle Management, Credentialing, Outsourced Coding, and Consulting Services to a number of healthcare providers in a variety of specialties. To find out more about MedCycle Solutions services please visit www.MedCycleSolutions.com.
Apr 6, 2022 | MedCycle Solutions, Partner
Although Telemedicine has been around for years, it was really the COVID-19 pandemic that expedited the need for implementing these services rapidly and on a larger scale.
According to Medicaid.gov “telemedicine seeks to improve a patient’s health by permitting two-way, real time interactive communication between the patient, and physician or practitioner at the distant site.” This can be accomplished via telephone, video calls, or through web-based applications utilizing a microphone and video camera.
In our previous article, 4 Ways Telehealth Has Changed the Landscape of Patient Care, we discussed ways practitioners can provide safe, necessary patient care while providing a cost-effective alternative to augment revenue.
To assist in navigating telemedicine/telehealth, we’ve provided five telehealth links for providing healthcare.
1. Telehealth for Providers: What You Need to Know
The Centers for Medicare & Medicaid Services (CMS) provides a 17-page document with electronic links for telehealth and telemedicine. This resource is for providers who wish to establish permanent programs. It includes links to vendors, patient monitoring, documentation tools, etc.
2. CMS List of Telehealth Services
The CMS have made available resources for medical billing and coding. This resource link contains the 2022 medical coding schedule for allowed services for Medicare telehealth services.
3. How to Get or Provide Remote Health Care
The Health Resources & Services Administration (HRSA) provides information for both patients and providers on telehealth services. Providers can get information on remote care, find recent COVID-19 reimbursement, billing, and policy changes.
4. Introduction to Telehealth for Behavioral Health
The HRSA provides information on getting started with providing Behavioral Telehealth. This may also be referred to as telebehavioral health, telemental health, telepsychiatry, or telepsychology. There are resources for developing a Telehealth strategy, billing, and preparing patients along with many other resources.
5. Is Telehealth Viable for Mental Health Needs Post-Pandemic?
The American Association of Post-Acute Care Nursing (AAPACN) provides an in-depth article meant to help nursing home facilities walk thru providing mental and behavioral healthcare in its facilities. Prior to COVID-19, long-term care facilities didn’t see the need for technology. COVID-19 proved that by utilizing smaller technology, such as iPads, residents are able to get safe, immediate mental and behavioral health care.
MedCycle Solutions provides Revenue Cycle Management, Credentialing, Outsourced Coding, and Consulting Services to a number of healthcare providers in a variety of specialties. To find out more about MedCycle Solutions services please visit www.MedCycleSolutions.com.
Mar 15, 2022 | MedCycle Solutions, Partner
By Ranadene Tapio, MBA, CMRS, CPCS
As healthcare delivery gets more complex, patient reimbursement decreases, and patient demand increases, practices are forced to reevaluate their revenue cycle management (RCM) process.
Some people underestimate the importance of effective revenue cycle management. RCM is the lifeblood of your practice. It determines almost all key performance indicators and practice health.
Along with the obvious indicators, here are six positive impacts that effective revenue cycle management has on a healthcare practice.
- Collections. An effective RCM process will include a strategy for collections. This should include prompt reminders, multiple payment options and other collections best practices.
- Productivity. A commonly overlooked benefit of an effective RCM strategy is increased productivity for your staff. Your team will be able to spend less time chasing collections, correcting erroneous codes and reinventing the wheel. A well laid out process will be easy to follow and more efficient.
- Team morale. Along with increased productivity, you’re likely to see a boost in team morale as a direct benefit of a defined RCM process. When employees are productive and accomplishing goals, they are happier and find more satisfaction in their work. It’s a win/win!
- Bottom line. Possibly the best benefit of optimizing your RCM is an improved bottom line. You’ll be collecting more, spending less, attracting more patients and being more productive. Whether they’re hard benefits or soft benefits, they’ll have an impact on your bottom line.
- Patient satisfaction. With a well formulated plan in place, your practice will be running more efficiently and effectively. Patients will notice the difference that comes in better efficiency, communication and processes. In many practices, these benefits are noticed by the patients in the forms of less wait time, quicker registration and overall a more organized delivery of care.
- Compliance. An effective RCM process helps ensure compliance and protection of patient data. When a process is followed, fewer errors are made, which leads to fewer compliance issues.
Is your RCM process optimized? Is it well-developed, well-defined, and well-understood by your staff? Are you reaping the benefits of a healthy revenue cycle management process?
There are many great organizations that can help you in these areas – MedCycle Solutions is one of them. If you’re wondering how partnering in these areas could work for your practice, let’s connect.
Ranadene (Randi) Tapio, MBA, CMRS, CPCS is the Founder and CEO MedCycle Solutions, which provides Revenue Cycle Management, Credentialing, Outsourced Coding, and Consulting Services to a number of healthcare providers in a variety of specialties. To find out more about MedCycle Solutions services please visit www.MedCycleSolutions.com. You can reach Randi via email at Randi@MedCycleSolutions.com or call 320-290-6448.
Mar 8, 2022 | MedCycle Solutions, Partner
By: Winona Thomas BS HCS
According to Kaiser Health News, there has been a spike in retroactive denials for emergency department care and more patients are being caught in the middle of possibly becoming responsible for unresolved hospital bills.
Healthcare providers along with healthcare payers are finding challenges with keeping up with the evolving government guidelines for correct claim submissions of COVID-19 billing procedures. Challenges such as unnecessary claim denials, underpayment of claim payments or payment delays, and retroactive claim denials may pay tribute to increased volumes of patient billing.
In an article written in the Healthcare Financial Management Association (HFMA), Revenue Cycle leaders provide 4 tips to keep ahead of denials amid the pandemic.
- Pinpoint the most at-risk areas – Identify areas where providers are most likely to have difficulties keeping track of varying payer requirements introduced a new level of intricacy to claim processing.
- Strengthen team communications – As the workforce transitioned to a remote environment due to the pandemic, for health systems, that meant remote revenue cycle processes had not been fine-tuned across functions, presenting challenges for areas such as customer service and claim processing.
- Proactively manage relationships with payers – An organization’s ability to identify changes to payer rules around COVID-19 and telehealth claims, in real time, and keep staff informed on the variances in billing rules by payer is essential to denials prevention.
- Increase payment flexibility for patients – Health systems ramped up patient payment options — from self-service options to payment plan offerings – to ease consumers’ financial fears ex
One of the key components for healthcare providers is to be proactive with the implementation of new revenue cycle processes and procedures to facilitate improved payment and denial management strategies with healthcare payers and the consumer population.
Winona L. Thomas, BS HCS is an Account Specialist and Writer at MedCycle Solutions, which provides Revenue Cycle Management, Credentialing, Outsourced Coding, and Consulting Services to a number of healthcare providers in a variety of specialties. To find out more information about MedCycle Solutions services, please visit www.MedCycleSolutions.com.
