Revenue Cycle Management – Ensuring your Practice’s Fiscal Stability


The pandemic interrupted a lot of proven processes in medical practices – both clinically and financially. Virtual visits and distancing protocols made it more difficult to ensure insurance companies were reimbursing at an appropriate rate and co-pays were collected in a timely manner.

Data collected through practice tools and a nationwide practice survey showed most practices were hardest hit by the reduction in new patients. According to Susan Weidner, Senior Vice President of IntrinsiQ Specialty Solutions, practices saw a decline of between 40–85 percent of new patients, regardless of the specialty. In tandem, they also saw a 7–14-day delay in medical claims submissions.

While practices may have taken advantage of the government financial programs for small businesses, starting back in a post-pandemic era will present its challenges. While patients may return, practices will have to book increased schedule times for patients and follow-up cleaning procedures, and different methods for confirming insurance payments and co-pays.

Looking at the current denial trends and the trending in your practice before the pandemic may illustrate some opportunities to change processes, while you undertake a change in clinical operations. Resolving denials or resubmits to just a few days rather than a week or two will help stabilize your finances.

With all the operational changes due to the pandemic, practices may not have the time to maximize the use of their practice management (PM) systems for reporting. Having those reports set up automatically to be reviewed on a timelier basis and setting a schedule for review will help your practice with a more automatic process.

Physicians and staff will also be adapting to new SOPs that include some distancing and cleaning, taking additional time during the day away from direct patient contact. Understanding how the providers are being benchmarked against other practices and providers during similar time frames will help you reinforce the new procedures. Monitoring progress by looking at reports by payer, practice and CPT codes from pre- and post-pandemic may help you identify opportunities for improvement in processes or reporting.

Practices will also probably see more patients who have lost their third-party insurance or will not reach their deductible by the time they expected. Working with those patients and reviewing your policies will be critical to your financial success.
 
The Business Optimization Team is ready to help practices stabilize post-COVID-19. With specialty practice expertise, they can help assess your business, develop an implementation plan and establish best practices to get prepared for the future. To discuss how they partner with you, email practiceconsulting@amerisourcebergen.com.
 

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