Your practice’s revenue cycle management is the process of collecting, tracking, and reporting on your payments from patients and payers. If you’re not collecting 100 percent of your revenue, it’s not only costing you money—it’s also hurting your reputation with patients who may decide to go elsewhere when they have a choice. Even worse, failing to collect all of the money due to your practice can result in penalties and potential legal action if one of your patients ends up having trouble paying for something.

Many practices make the mistake of assuming that if they collect patient-pay and insurance payments prior to a procedure, they will have no remaining receivables. But a successful practice must look at the following three key factors to implementing a successful revenue cycle management process:

To manage the revenue cycle more effectively, there are three key factors to keep in mind:

• Revenue management
• Eliminating A/R
• A/R management

Revenue Management

Revenue management is the process of managing the amount of money that a business receives from customers. it’s important that you know how a practice’s revenue management works and how it affects the patient’s access to care.

Eliminating A/R

A/R management is an important aspect of your practice that helps you collect your accounts receivable. Effective A/R management can significantly improve the cash flow in your practice.

While many practices focus their time and effort on bringing in new referrals, it is equally important to spend some time managing the accounts receivable process so that all of your hard work will be rewarded.

A/R management

A/R management is an important part of running a practice. If you are not collecting your revenue, then you will have problems paying your bills. The first thing that you need to do is understand why the A/R is not being collected. It could be because of any number of reasons such as:

• The patient does not have the money to pay
• Your invoices sent out are too complicated or confusing
• You haven’t been sending out reminders when they were due.

To address these problems and get those claims paid, there are some steps that you can take:

1.  Keep track of all unpaid claims so that they don’t get lost among other papers in your office – this will help prevent late payments from happening again. 

2. Be sure that anyone working on billing understands how important it is for them to send out claims about upcoming deadlines for payment before time runs out for collection purposes; otherwise, there won’t be anything left in their accounts at all! Remember also never let any items go past 180 days without sending out reminders–this usually results in more debt collectors coming after us later down the road which costs more money than simply doing things correctly upfront.”

The best way to ensure you are collecting every cent of your revenue is by using an efficient and effective revenue cycle management solution.

When it comes to revenue cycle management, there’s no such thing as “good enough.” The best way to ensure you are collecting every cent of your revenue is by using an efficient and effective revenue cycle management solution.

A good quality revenue cycle management system will help you:

• Automate processes in order to house more patients and increase revenues
• Reduce expenses and increase patient satisfaction through better communications between the front desk, doctor offices, and back office staff
• Improve productivity by streamlining workflows across multiple locations

Conclusion

The key to successful revenue cycle management is understanding the three factors of revenue management, eliminating accounts receivable, and A/R management. These are all critical processes that must be in place in order for any practice or business to maximize the potential of its collections and stay profitable.

The revenue cycle management method relies heavily on payment posting. Payment posting, when done correctly, can improve your practice’s cash flow and income.

In medical billing, what is Payment Posting?

The process of applying remittances to patient medical accounts and reconciling those payments with outstanding bills is known as payment posting. When a patient pays a bill, the payment must be applied to the appropriate bill and patient. Because it takes time for a practice to collect payments, it’s critical to handle adjustments and denials rapidly to avoid cash flow lags. Medical billing might take weeks or months to complete. Billing issues lengthen the duration and make accounting and recordkeeping more difficult. Payment posting problems can also lead to denials, uncertainty, miscommunication, and dissatisfied patients.

What Is the Importance of Payment Posting?

Patients and your practice benefit from accurate payment posting. Practice managers find solutions that don’t irritate patients or result in revenue loss.

Payment posting that is accurate and timely has various advantages for your practice, including:

Accurate payment posting provides insight into the practice’s revenue and day-to-day financial activity. Your office gets a complete picture of your financial situation. These reports help people make better financial decisions.

Prevent Discrepancies – Efficient payment processing in medical billing allows your practice to discover discrepancies before they become problems that affect your revenue cycle.

Detect Errors – With proper payment posting, your practice will be able to detect payment errors before they become major issues. Check the status of payments on a weekly basis to verify there are no errors. 

Increase Cash Flow – Make sure your system is error-free to boost your practice’s cash flow and income.

Identify Recurring Issues – By tracking payment posting, you can identify recurring issues in your revenue cycle. Then, address the faults to develop efficiency inside your accounting operations.

Make Your Payment Posting Process More Efficient

Monitoring your payment posting procedure boosts revenue and efficiency in your practice.

The following aresome of the most prevalent techniques to improve your posting process: 

Empower Your Staff

Is your front-desk staff correctly collecting copays? Is it true that denials are being resent to the payer? Make sure your payment posters are familiar with medical billing software and your payment processing protocol.

User error in payment processing is avoided by paying special attention to training. Additionally, ensure that your staff is aware of any recent changes to billing or coding standards, as this will help you avoid problems with medical insurance companies over patient payments.

Recognize Errors and Trends

Payment posters in your practice should be trained to correctly highlight concerns like previous authorizations or non-covered treatments for the practice manager’s prompt notice. Problems or discrepancies are resolved more quickly when they are addressed quickly.

Make use of ERAs and EFTs.

ERA and EFT payments are preferred by 85 percent of clinics, according to Med Data. Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT) are two electronic payment mechanisms used by businesses and institutions.

HIPAA-compliant electronic platforms that can replace paper versions of EOBs are known as ERAs (Explanation of Benefits). ERAs minimize the number of payments that must bemanually input, which is time-consuming and error-prone. ERAs can also be  applied to other benefit packages. EFTs are the tools used to send those payments.

Do you have any queries about how to post payments in your practice?

The wws can help you examine  your revenue cycle management, including any payment posting problems.

The law’s main premise is that a payer must reply to a valid claim within a certain amount of time (usually around 30 days for electronic claims).

In order to efficiently use the clean claim rule, your medical billing process must have a tracking system that flags:

• Which insurance firms are covered by your state’s clean claim statute (some are exempt)?
• The date on which your clinic submits each medical claim for the first time;
• Events that bring the clean claim clock to a halt (e.g., an information request from the payer),
• When your practice has responded to payer requests by taking action;
• The date on which you received the final adjudication decision from the payer.

The prospect of carefully tracking all of this data may seem intimidating, but with the right system architecture, it is both achievable and desirable. Your claims will pay faster after you file a few Clean Claim law violation reports. I’ve witnessed cases when payers have contacted solely to reassure the practitioner that claims will be processed swiftly.

Running a trial on a payer that frequently takes more than 30 days to adjudicate claims is one method to quickly get started using the clean claim law. Find a small number of significant claims for this payer that have been open for more than 30 days and run a test with them. This will enable you to understand the foundations of how to file, monitor, and view the results of complaints.

Tips for Getting Your Medical Practice to Have a 95% Clean Claims Rate

How can your medical practice attain a clean claims rate of 95%? Despite the fact that this may appear to be a tall goal, there are several medical billing tactics your medical practice may apply to help increase your clean claims rate – and your entire revenue cycle management!

Keep patient records up to date.

There’s a lot of patient information that can change—and change quickly—from contact information to insurance carriers and more. Patients must check or update their current information before getting treatment, as faulty patient data is a leading source of denied claims. To reduce delays, use exact documentation to help check patient information ahead of time, and have patients update their paperwork at every visit (or even sooner with automated reminders).

Prior to the date of service, double-check your eligibility.

Patients that come to your office on a regular basis are known as established patients. They’re also the patients who your employees might presume haven’t had any recent insurance changes. Most denied claims, however, are generally the result of outdated established patient insurance information. Collecting and confirming every patient’s primary, secondary, and even tertiary insurance at least five days before their scheduled service is one step toward a 95 percent clean claims rate.

It’s also vital to double-check any in- or out-of-network benefits, copays, or deductibles.

Keep in mind the deadlines for filing insurance claims.

In most cases, filing a claim necessitates submitting it within a specific time frame. Any claim submitted outside of the window will result in a higher number of refused claims.

 If you want your practice to have a near-perfect clean claim ratio, one of the best ways to do so is to pay attention to claim deadlines and handle any concerns with patient coverage prior to their date of service so the claim is not submitted late. Aim for authorization between three and five days prior to service as a best practice.

Even the cleanest, most well-documented claim can often take weeks, if not months, to process. In the meantime, the practice loses out on revenue. This is why many of them opt to have their billing handled by a third party. Ultimately, WWS contributes to a smooth, continuous flow of revenue that benefits the bottom line of health practices. Contact WWS today to learn more.

When it comes to accounts receivable, how well do you know your cash flow? Many medical practices treat their accounts receivable (A/R) statistics as a black box of misinformation, when in reality, it’s one of the most crucial figures to comprehend when assessing your practice’s financial health.

Accounting for Accounts Receivables

Accounts receivable is a high-touch aspect of every medical office, as it is the money owed to your practice for services given and billed. It can be difficult to acquire a holistic understanding of how long it takes you to get paid if you have a big number of administrative personnel overseeing different patient accounts or specialties.

Why should you keep track of your accounts receivable turnover?

If patient visits are consistent, incoming cash should be as well – which is why it’s critical for medical practices to know how long it takes between bills being sent out and payments being received.

The accounts receivable (A/R) of a practice reflects how many payments have yet to be received, whether for insurance reimbursements or out-of-pocket expenses. The goal of a healthy medical practice is to streamline procedures in order to get paid faster, which could include minimizing billing and coding errors or improving claim follow-up. Keeping track of how long claims spend in A/R can help practices figure out which payers are delayed and why.

You can notice whether your team is late to submit claims to payers by knowing the average number of days between when you visit a patient and when you collect what you’re owed. You’ll also know how much money you need to retain in the bank – and for how long – to cover your running costs until refunds arrive.

Invoicing on time

Prepare and send your invoices as soon as possible after providing medical services on credit. The client’s name, account number, date of transaction, description of medical services given, any discounts granted, and total due amount should all appear on each invoice.

After transferring your accounts receivable to your sales journals and general ledger accounts, these facts are critical for tracking them. Invoices are also important in the event of future problems or disagreements, such as overcharges and undercharges. Make sure your clients have received their invoices by making follow-up calls.

Patients Should Be Informed

Most patients have only a hazy grasp of how healthcare practices collect payments from insurance companies, and they may be unaware of their financial responsibilities when they use medical services.

Providing all patients with a pamphlet or reference sheet outlining their position and duties in the payment process will help to clear up a lot of misconceptions. It’s also crucial to have someone on staff with financial knowledge who can answer any questions patients might have regarding the claims and payment process.

WWS has decades of coding and billing experience for a variety of healthcare practices. We recognize that each practice is distinct and deserves a tailored solution that supports its long-term objectives. That’s why we collaborate closely with our clients to help them set up medical billing services and solutions that are tailored to their individual needs and enable them to provide the best possible care.