Back to Basics: The Back End of Revenue Cycle

This is the time of year when we reflect more on our businesses and make plans for the coming year.  The health of the back end of your revenue cycle has a heavy impact on the financial successes and opportunities for improvement experienced by your practice.  Once the physician’s encounter has closed, it moves in to the back end of the revenue cycle which is comprised of the billing process – charge review, claim submission, posting, follow-up, and collections.  Who works the back end of your revenue cycle?  Do you have staff in your office who handle your billing?  Have you decided to outsource the management of your revenue cycle?

Whoever handles this very important piece should consider the following.  Are you doing these things in your practice when it comes to the back end of revenue cycle?

Revenue Cycle Back End Basics:

• Full charge review to ensure correct modifiers and complete charge capture

• Do you have certified coders reviewing all charges?

• Timely submission of charges – within 48 to 72 hours of the close of the encounter- and timely posting

• Thorough, timely, and persistent follow up on all charges not paid and appeal of denied charges

• A specific plan for collecting outstanding patient due balances, including a mix of statements, letters, and phone call outreach

• Consistent review of reports to track the health of your revenue cycle, including bench-marking key data points against industry key performance indicators