It happens to the best of them — managers, administrators, and physicians — in all kinds of practices, of all sizes. One day they reach an “aha!” moment in billing and realize they need help.
“We were always falling behind,” said Joel Link, billing manager at Affiliated Medical Associates, recalling his own moment of sudden insight. “There was a lot of pressure on us. The doctors were not happy because money wasn’t coming in the way it should in the time that it should.”
Dr. Calvin Walker remembers his “aha!” moment, too: “The interim billing service we were using did not have a clue how to bill for psychiatry. We literally had no income.”
Positioning your practice for value-based care while staying financially healthy in a challenging regulatory environment means knowing how to get paid for your services — from handling claim denials and underpayments to following up on outstanding payments. But it’s not easy.
When those daily billing pains begin to mount, and office managers and practice administrators finally realize they’re losing money, they often feel they have no choice but to seek help. Many practices are partnering with teams of revenue cycle management experts focused on collecting every dollar they can.
Matching revenue to care delivery
It’s a match that makes sense, especially in today’s ever-changing regulatory healthcare environment.
Value-based care programs, changing payer fee schedules, employee attrition, government regulations, lackluster training and oversight, high-deductible health plans — there are many reasons your practice might not be bringing in the revenue that it’s truly earning.
To make things even more challenging, many practices face future financial penalties for past non-compliance with regulatory programs. It’s vital to make sure your practice is prepared for impending financial penalties while also focusing on new government programs, understanding payer fee schedules, and collecting the most from your patients.
Joel Link said a big part of his struggle was dealing with days in accounts receivable (A/R). “Obviously the longer it takes to get the money, the less money you’re going to get. Once it hits 120 days, you’re getting 10 cents on the dollar, on average. Keeping the majority of claims under 60 days is essential.”
Partnering for success
Once you’ve reached the breaking point and you know you need additional help, it’s time to weigh your options. Whether your goal is to remain independent, grow your practice, or simply improve your cash flow, it usually comes down to deciding whether you hire additional employees or bring on a revenue services partner.
There are many factors to consider, of course. For example, when hiring additional or new billers, will the monetary investment (wages, benefits, vacation) be worth the return? Who will train staff, and when? Who will complete billing tasks when employees are sick or on vacation, or quit?
If adding additional billers doesn’t sound like the right solution, partnering with a team of experts might be the answer. But hiring a partner doesn’t mean you have to let go of your dedicated staff. Their knowledge can be transferred to revenue-producing roles within your practice.
“I like the close working relationship that I have with our Greenway Revenue Services team. Our patients know that their accounts are being handled in a very professional manner.”
Dr. Calvin Walker, practice owner
Click here to learn how the Greenway Revenue Services team can help fix your broken revenue cycle.