How to Lower Leakage in Healthcare Revenue Cycle Management

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How to Lower Revenue Leakage in Your Medical Practice

Whenever or wherever a revenue leakage report surfaces, you’ll find that there are alternative solutions, methods, and strategies to fix such leaks. In order to prevent these problems from impacting your practice, it’s important to keep yourself prepared and overcome the loop-holes in your healthcare revenue cycle management.

Source: TechTarget

Read on to find which revenue leakage factors can adversely impact your practice’s financial health, and learn how to reduce them.

Reimbursements and Underpayments

Both reimbursements and underpayments should always have proper tracking.

You must ensure a thorough system that helps your billing staff record and conduct a proper follow up to recover shortfalls with the private or public payers. Creating a monthly report will identify the short payments that are missing or not calculated properly. 

Reconcile Bills or Claims 

You can easily lose service money, fees, or consultations charges if no reconciliation process is implemented. At any stage, the billing amounts can appear as profits in net profits.

However, you should work to ensure the proper recording of your appointment schedule; this will give you a fair idea of how appointments are reflected in the system, and whether they constitute cancellations, reschedules, or no-show appointments.

Furthermore, if necessary, you can get an unbilled charges report from management to locate any missing charges.

Credentialing Issues

Changes in your practice may lead to additional deferred or rejected claims which will take a long time to resolve. As a result, it is vital to outsource your medical billing. Choose an outsource billing company that has all the forms, payer rules’ knowledge, and relevant software to track  re-credentialing dates.

Poor Patient Balance Management

An imbalance will decrease the percentage of claims reimbursements to all service providers in your industry. It is recommended to manage and collect the outstanding dues to avoid problems occuring during audits. Moreover, you can transition to electronic statements and provide the option of a payment portal for patients. 

Out-dated or non-compliant Software and Systems

Although no software is perfect, obsolete or non-compliant software will cause multiple issues.

If your systems are slow or require data calculations, revenue leakage will increase. So, make sure to review your software on a regular basis and update or replace your programs when possible. 

Front Desk or Staff Issues

Front desk employees are the backbone of your practice. They schedule appointments and input important patient information in the system that includes their medical condition, patient history, and insurance information. Any and all mistakes like omissions or wrong data feeding will create havoc in the system. 

Therefore, it is important to monitor the work of your employees and work to ensure that their work is correct and meets the standards of your practice.

Deficient Reporting

Most systems have no tracking procedure to keep payer denials intact, whether paid or unpaid. Claims can get lost in a system until they reappear on Aging Reports. Commonly, management systems don’t catch this category of lost revenues; they reappear too late, and payers will refuse to pay their balances.

You can fix such leakages by creating a monthly reporting package to address requisites for such cases. A revenue management consultant will advise which information is suitable for the reporting.

Nothing Slips Through the Cracks, ever, with NCDS Healthcare Revenue Cycle Management

Keep your practice financially healthy. By utilizing a top-notch medical billing software, your business will be able to keep revenue leakage at a minimum.

Our expert consultants will review your reports, trends, industry changes, and policy updates to provide your business with the right feedback and solutions to improve your entire billing process. To learn more about our commitment to excellence and performance for medical practices and healthcare providers or for questions regarding our tailored revenue cycle management solutions or other medical billing services, connect with us today.

References 

https://www.viaante.com/2020/08/14/9-steps-to-restrict-revenue-leakage-in-medical-billing/

https://www.precisionpractice.com/top-10-revenue-leakage.html

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