Revenue Cycle Management: Identifying Myths and Opportunities
We had the great opportunity to interview Elizabeth Woodcock, the founder and principal of Woodcock & Associates. Below we bring you some of the excellent advice she shared with us.
Your practice exists so you can treat patients and help keep them healthy. But, in order to do this, your practice has to be healthy as well. Financially healthy. You need successful processes, procedures and policies. That’s where revenue cycle management comes in.
Without proper revenue cycle management, your practice simply can’t survive. Regardless of the size of your practice, revenue cycle management is absolutely critical to its success. The revenue cycle marketplace has seen a lot of innovation in recent years, and it will continue to evolve, especially as health insurance continues to change and new trends begin to emerge. Making sure your staff is trained on all elements of the revenue cycle – both front-end and back-end – is imperative to the process.
Below are some common myths or misconceptions amongst front desk staff that if corrected, can begin to change the financial health of your practice:
Myth #1: I can’t collect at the point of service because I am contractually obligated not to by the payer.
Truth: Generally, payer contracts do not prevent you from collecting payment from the patient at the time of service. And while understanding each patient’s responsibility and being able to collect accurate and necessary payment requires more education, it is a very important piece to ensuring the financial health of your practice. There may be some requirements related to point of service collections included in the payer contract that you need to determine, but typically prevention from collecting at the time of service is not one of them.
Myth #2: I can’t communicate with the insurance companies online and I don’t have time to call them.
Truth: There are many technological advances, including automation, that have taken over industries today, and the insurance companies are no different. Automation allows for many efficiencies, but only if your staff is equipped to handle it. It’s extremely important that you are hiring employees who are technologically proficient in order to keep up with the demands of your changing practice.
Myth #3: I don’t need to collect from the patients at the time of service because they may not be responsible for it and it’s not significant anyway.
Truth: Understanding patient financial responsibility is a huge challenge today, especially with the changing landscape of how much patients owe in contrast to how much the insurance company owes. But, collecting what the patient owes at the time of service is a very important factor in the success of your practice. Education is crucial.
What is the bottom line? A streamlined and efficient revenue cycle is critical to the success of your practice. This includes properly trained and educated staff who understand the landscape and what is involved in these often complex processes and procedures. Your goal should be to have front desk staff that can change how we manage patient communication and patient collections for the better and help keep your practice and your patients healthy.
Elizabeth Woodcock is the founder and principal of Woodcock & Associates, having focused on medical group operations and revenue cycle management for more than 25 years. The author or co-author of 17 books, including the best-selling Physician Billing Process: Avoiding Potholes in the Road to Getting Paid, she is a nationally recognized practice management speaker and trainer. Elizabeth is a Fellow in the American College of Medical Practice Executives and a Certified Professional Coder. In addition to a Bachelor of Arts from Duke University, she completed a Master of Business Administration in healthcare management from The Wharton School of Business of the University of Pennsylvania.