The MGMA estimates that, on average, U.S. medical practices are failing to collect 25% of the money they’re owed for treating patients. That means $125 billion is left on the table every year.
Power Your Practice understands the challenges medical practices are facing in accounts receivable and is here to help. Every week during our A/R Best Practices series, we’re describing the must-have features managers need to look for in practice management systems to manage and collect all of their receivables.
Innovative Tools Make Practice Management Easier
The most effective A/R management applications need a variety of advanced tools to greatly improve a practice’s efficiency and workflow. The features that will benefit practices the most are:
1. Work queue for collectors – The system should be able to send information and assignments to collectors and queue up an automated list so they can work quickly.
2. Skills-based routing – The system should be able to automatically send assignments to employees with the appropriate skill sets. For example, the practice can identify an employee as a Medicare specialist and the system can automatically send Medicare denials to that person.
3. Advanced tracking – Practices should be able to track all denials, underpayments, and lost or ignored claims and charges for a better-organized workflow.
4. One-click action – All tasks within the system should be as easy and intuitive as possible. Common collection item needs – resubmissions, appeals, electronic eligibility verification, demographic and insurance data changes – should be able to be accomplished with one click.
5. Electronic claims status checking – Many payers allow the practice to check the status of their claims electronically so they can easily know when to expect payment or when to follow up on a claim. Make sure you choose a system that can connect with your payers and allows electronic status checks.
6. Advanced organization – One of the appeals of using an electronic system is the ability to store and easily access all A/R data in the same place so they can make better decisions and improve collections. Therefore, the system allows practices to sort denials by payer, responsible party, provider, payer type, billing amount, and any other category.
7. Tracking expected value of denials – Practices need to know how much denials are costing them so they can assign collection resources appropriately.
8. Standardized denial types – Finally, the system should be able to categorize denials based on their type – for example, justification, enrollment, authorization, coverage, medical necessity, and others. These denial types should be able to be standardized into the same category themes across different payers. That gives practices another data point to analyze when trying to minimize denials.
A/R Best Practices: In Conclusion
The revenue cycle for medical practices is complex and tough to manage. That’s why it’s more important than ever to get a handle on the process and efficiently collect more of the money your practice is owed.
Installing your first practice management system or upgrading to a different system with the features described above is one major step toward improving your practice’s accounts receivable operations.
Better billing and collections not only saves practices money and adds to their revenue, but also allows medical practices to focus more time on what they do best – caring for patients.
How do you plan to optimize accounts receivable in your practice?
