One of the things we spend a lot of time helping our clients with is uncovering areas in their practice where they are losing revenue. For many practice owners and doctors, it can be hard to find the time to focus on many of the day-to-day business tasks that your staff are responsible for but that ultimately have a huge impact on the revenue your practice generates. And, often, even when you find the time it can be overwhelming to know where to even start to look or what you should be looking for.
From over 20 years of helping practices we’ve compiled this Ultimate Guide on where to spot revenue leakage in your practice, some of the common pitfalls, and how to overcome them. Follow along below, download our free tools, and check out the complete articles in our series on Review of Optometric Business.
Operational Gaps That Derail Payments
Read the Full Article on Review of Optometric Business: Why Am I Not Getting Paid? Administrative and Operational Challenges Could Be to Blame
While delivering quality patient care is the primary focus of any eyecare practice, many practices struggle with the operational backbone needed to support the revenue you should be generating from the care and services delivered. From the moment a patient schedules an appointment, every touch point matters, and your front desk team plays a pivotal role in documenting accurate and complete patient information.
Common Operational Billing Gaps:
- Eligibility verification
- Human errors leading to incorrect information
- Missing documentation
- Inconsistent patient communication of benefits
- Credentialing errors
- Lack of staff training or understaffed offices
Solutions to Build More Efficient Operations:
- Utilize real-time eligibility verification tools
- Use digitized intake forms
- Develop standardized checklists for different services to confirm documentation requirements
- Communicate patient benefits at check-in
- Invest in regular training sessions
- Consider outsourcing to specialized billing services
Take Action:
- Grab your Claims Responsibility Flowchart
- Assign one team to oversee claims from end-to-end
Workflow Mistakes That Cost You Money
Read the Full Article on Review of Optometric Business: 11 Reasons You Are Not Getting Paid: Top Workflow Pitfalls
Even when you think your process is tight, the tiniest workflow errors can cause claim rejections, delays, and denials and can exponentially pile up over time. This next section takes a deeper look at some of the specifics in your billing workflow that could be causing revenue leakage.
We like to call this process of evaluation the Charge Capture Audit. With a Charge Capture Audit we start at patient check and follow the claims all the way through reimbursement to see where issues occur.
Common Billing Workflow Pitfalls:
- Incorrect coding
- Missing or misused modifiers
- Duplicate claims
- Claim submission errors
- Clearinghouse issues
- Late claim submissions
- Bundling mistakes
- Failing to track claim status
- Mismanaged write offs
Solutions to Strengthening Your Workflow:
- Conduct monthly audits to identify repetitive errors
- Establish proper training and documentation of process
- Integrate modifier checks
- Track claims in real time
- Centralize internal billing communications
- Utilize reporting systems
- Set reminders
- Review AR monthly
Take Action:
- Download our ebook, 9 Billing Solutions from the Front Desk to the Back Office
- Document your current billing workflow and identify gaps and opportunities for improvement
Accounts Receivable Chaos
Read the Full Article on Review of Optometric Business: Hidden Costs of Poor AR Management that Lead to Lost Revenue
You can do everything else right, but if you don’t stay on top of your AR, it’s like filling a leaky bucket. Effectively managing your AR keeps cashflow running smoothly, and ensures you’re capturing all the revenue you’ve earned for your practice.
Common AR Management Challenges:
- Aging AR balances over 90 days
- Patients unsure of what they owe
- Billing fees under the allowable reimbursement rates
- Payments not being posted
- Missed follow up on denied or rejected claims
- Skipping monthly reviews of AR
- Patient billing pushed off indefinitely
- Outdated fee schedules
Solutions for Successful AR Management:
- Monitor your AR aging monthly, if not weekly
- Collect patient responsibility payments at time of service
- Assign a team member to track and follow up on outstanding payments
- Automate patient billing reminders
- Enroll in EFTs payments
- Consider outsourcing AR management
Take Action:
- Schedule a practice assessment to understand where your gaps and opportunities are
- Block time weekly for AR follow-up or consider outsourcing it
Get Help Where You Need It
At the end of the day, there are so many little details that go into managing a successful revenue cycle for your practice. And with staffing challenges, team members on leave or vacation, or just running a high volume practice – you might need experienced help to get your revenue cycle on track. OMS is here to help you with whatever your billing and insurance needs may be. From a practice assessment to monthly RCM support to payment posting, our team can help you where you need it most.