The transition to value-based care has created a necessary shift in the way healthcare is delivered. Key among shifting priorities for medical practices is the need to demonstrate how quality care is delivered at a lower cost. While the concept of leveraging technology for efficiency may not be new, a renewed mindset has become necessary. Medical practices in the current healthcare environment must adopt growth strategies that go beyond medical expertise to include creative tactics that identify revenue opportunities at every point in the operational cycle.
Reorganizing your practice to deliver value has multiple advantages – for both your patient base and your bottom line. This is where a good first impression of your practice could make a big difference. In an age where reimbursement is shrinking, your ability to leverage your practice management software and existing innovative technology could make the difference between solvency and insolvency.
Incorporating technology into your operational workflow can boost efficiency and effectiveness. Here are four ways that you can leverage technology to add value to your financial management processes:
- Reviewing and auto-posting charges seamlessly transmitted into your practice management solution from your electronic health record.
- Processing prior-authorization requests and responses.
- Claims submission: claim status requests and responses; claim acknowledgement and confirmation reports; automatic check deposit and electronic remittance advice; auto-posting of payments and auto-filing to secondary carriers.
- Point-of-care payment processing: collection of future payment authorizations to eliminate the need to send hard-copy patient statements and collection letters.
Remaining competitive is crucial to today’s forward-thinking medical practice. Outlined below are some suggested strategies that highlight technological solutions to transform operational workflow. These strategies are designed to support care delivery that is accurate, thorough, and consistent.
Monetize that first impression!
With a patient population that is increasingly becoming more informed, self-referring patients tend to conduct some level of research prior to engaging with the practice. An efficient front-desk and business-office workflow is a vital part of a patient’s total care experience. Online portals integrated with your practice’s website could have a tremendous impact on a patient’s first impression of your practice. With a well-designed and intuitive patient portal, new patients can register and complete demographic, financial, and medical history forms to submit to your office far in advance of their scheduled appointment. Likewise, existing patients can update their demographic information, view and change their appointments, and request records and referrals. Both the practice portal and patient portal facilitate secure and effective communication with your office. Promoting the convenience of reviewing accounts and submitting payments via these portals can help reduce your accounts receivable (A/R) and collections overhead.
Anticipate opportunities for revenue loss prior to a patient visit, and act on them.
Align your appointment and scheduling processes with the broader goal of maximizing reimbursement. Using a solution that supports insurance eligibility verification even before a patient shows up for an appointment allows for the confirmation of a patient’s eligibility to receive insurance benefits with just the click of a button. A medical practice can reengineer its existing workflow to include eligibility verification as part of a checklist of actions to complete at the time an appointment is scheduled. Having full knowledge of a patient’s coverage, prior authorization requirements, coinsurance, copay, and deductible-met amounts can help ensure the correct amount is collected at the point of service.
Add a new angle to patient communication.
Automating appointment reminders via telephone, text, or email could drastically reduce “no-shows.” No-show reminders increase the likelihood that patients who missed their appointments will reschedule and show up for the new appointment. The benefit to your medical practice lies in avoiding any potential opportunity costs associated with a missed appointment.
Automated communication to patients shouldn’t stop at appointment reminders. Your medical practice can contact patients for a variety of reasons, such as notification of failed insurance eligibility, health maintenance reminders, soft collections, payment reminders, and mass communication messages. When carried out correctly, communication with patients can decrease your staff workload and help maintain a healthy bottom line.
Use data to inform business practice.
Practice management technology often offers real-time dashboards to track key performance indicators (KPIs) on a daily basis. Real-time data on KPIs, such as patient count at a given point in time, current A/R, number of days in A/R, as well as charge, payment, and adjustment tracking, can provide actionable insight into your medical practice’s state of affairs.
There has been an increase in the application of predictive analytics to address challenges in healthcare in recent times. The application of predictive analytics in healthcare can potentially impact quality and efficiency of care delivery in many ways. Predictive algorithms can complement existing decision support tools available to physicians. Additionally, healthcare organizations in collaboration with their insurance partners can gain insight into current and future insurance product costs based on predictive models.1 Business intelligence solutions integrated into a practice management solution can help aggregate data from disparate systems to facilitate the analysis of data. Finding the right analytics solution can provide a sound foundation for informed decision-making.
Partner with a reliable clearinghouse, and use electronic data interchange (EDI) solutions to your advantage.
A reliable clearinghouse partner can add value to your medical practice’s billing and claims management process. Through the use of a comprehensive set of clearinghouse solutions, such as claims status inquiry (CSI), electronic remittance advice (ERA), and denial management, the potential for revenue loss is reduced and your potential for maximum reimbursement is enhanced. Solutions for code and claim scrubbing could also increase clean claim rates and support accuracy as well as compliance.
Mobile technology has made it much easier for patients to have access to more data than before. Secure practice-patient apps, provider-to-provider messaging, and health information exchange apps that feed right back into the practice management software are more of a necessity than a luxury nowadays. Bottom line: Patients expect it.
Initial upfront and maintenance fees may be a deterrent to a small medical practice with a modest budget. However, physicians have more incentives now, more than ever before, to make an investment in implementing technology. Taking advantage of automation to effectively manage your revenue cycle can help eliminate inefficiencies that, in turn, can have a strong impact on your bottom line.
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