Originally posted by OPIE Choice
It all comes down to your revenue cycle management (RCM). No matter how good you are at serving your clients, or marketing, or attracting referrals, your practice can only be financially successful if your RCM processes are solid and you are managing each case as optimally as possible. We all know there’s nothing worse than not getting paid for services provided. If you want your revenue to stabilize and grow, you must make sure your administrative processes are in good shape.
Here are some tips for tightening up your billing procedures and growing your revenue:
INTAKE IS EVERYTHING
You absolutely must have a thorough intake process, with fully accurate data, if you’re going to be successful in billing for services for that patient. It’s also wise to use automated tools such as ZirMed’s in-chart eligibility, CGS’s “My CGS,” and Noridian’s “Noridian Medicare Portal.” All of these services help you to gather patient history and eligibility for services, including verifying devices that have been provided to the patient in the past and checking frequency limits for each billable service.
KNOW THE PAYER
Payer policies change fairly regularly. You have to make the time to stay abreast of these changes. If you don’t understand the rules of the game, how are you going to have a chance of winning? Study up on the administrative policies and clinical coverage of each payer.
VERIFY AND PRE-AUTHORIZE
It is important that you, and your patient, have a full understanding of insurance coverage prior to the delivery of any service or device. Take time, in advance, to verify coverage and to document all communication so you can be an advocate for your patient.
DENIAL ISN’T THE FINAL WORD
When a claim is denied, following up on that claim and making corrections or submitting an appeal is crucial. Most denials are related to errors that are easily avoided and corrected. In addition, track and teach on all denials and appeals that go through your front office. Transparency in this process brings about a team approach to predicting and preventing rejections and denials going forward.
TAKE TIME FOR TRAINING
We are often so busy working in the day-to-day management of the practice that we don’t take time out for training. This is a huge mistake which can have a huge impact on the bottom line. Billing procedures are constantly improving, payer policies are frequently changing, and technology is regularly adapting to the industry. Invest in your staff and in the future of your business by taking advantage of the education that’s available to you.
Slow down, aim for accuracy, use the tools available, and make your financial health a priority. It’s vital for you, your staff, and your patients that you invest in your fiscal well being.
Want to hear more from Lesleigh on RCM and financial health for your O&P office? Join us at Fundamentals of Excellence. November 5-7, 2018 in Austin, TX. Register Now!
Lesleigh has more than 25 years experience in orthotics and prosthetics. She is committed not only to helping the practice thrive, but also to make a difference for the people she encounters daily. She loves traveling, cooking, the outdoors, and her growing family.