Every day, vital revenues slip through the fingers of practices due to a lack of insightful payment data analysis. As the volume of data flowing through a practice increases, so should its revenues. But instead what grows is the potential for undetected losses.
CPAs and administrators can’t diagnose and treat the problem, though, until the practice does a better job of organizing and analyzing its data. When the right data cannot be located in a timely fashion, it’s the analytical equivalent of a no-show appointment. Time is wasted and opportunities are lost. But proactive analysis can be especially revealing and supportive when it comes to four key areas.
Insurance Eligibility and Billing
Healthcare practices routinely lose as much as 30 cents on the dollar due to avoidable errors and undetected mistakes. Bills are wrongly sent to patients when it is actually the insurance company responsible for the charges. That causes long collection delays, while damaging provider-patient relationships. Practices chronically use outdated billing codes, too. That generates lower payments than the practice is eligible to receive, each and every time that incorrect billing code is used. Collections are delayed or lost because billing systems lack the automation necessary to vigilantly track each bill – whether its to an insurance company or a patient. Those receivables need to be monitored through the entire life cycle of the bill, otherwise it can hurt the bottom line.
Centralized Data with Specialized Reporting
Healthcare facilities often operate sprawling or multiple sites. That increases the potential for decentralized information silos to develop and further complicate the problem. It becomes more cumbersome and costly to consolidate data in order to share it with accountants or regulatory agencies, including the IRS. Meanwhile, any practice required to submit reports for programs like MACRA and MIPS needs an efficient system that will ensure compliance and take full advantage of qualified reimbursements. To solve those challenges, data has to be captured and securely archived, with uniformly standardized formatting across all sites or platforms. Otherwise it’s harder to accurately aggregate the data in a searchable and retrievable form. That makes reporting more difficult while increasing the chance that reports that are generated will be inaccurate and misleading.
Overcoming Revenue Cycle Challenges E-BookLearn More
Programs like MIPS and MACRA are meant to serve a dual function of reducing the overall cost of healthcare while improving patient outcomes through best practices. How well that’s working is a topic of industry debate, but everyone agrees that the intention is good. The goal should always be to help patients achieve optimum results without undue financial burdens. Flexible and comprehensive reporting can provide analytical insight into diagnostics, treatment plans, and outcomes for individual patients, across any timeline. That helps ensure consistent care, identify lower-cost treatment options, and highlight and minimize no-shows. Analytics can also bring attention to generalized patterns in overall practice protocol, revealing opportunities for improved delivery of care and greater productivity.
Affordable Solutions to Expensive Problems
A full-featured billing, reporting, and eligibility management system can capture, secure, and standardize data in an easily retrievable and understandable way. Collection becomes more predictable and efficient. The automated software also facilitates data aggregation, centralization, and customized reporting. That means less labor with fewer chances for human error, plus faster processing of data, internally-shared reports, and bankable payments.