Despite your staff’s best efforts to remind patients of their appointments, you’re still likely plagued by one or two no-show events every day. The MGMA has estimated that medical practices average a 5% to 7% no-show rate.
But that’s not so bad, right? After all, you can’t expect every single patient to show up as planned, can you?
Perhaps you should. If the average visit in your office yields a $25 co-pay and a $90 reimbursement, just two missed appointments per day can cost your practice nearly $60,000 per year. And that estimate excludes the administrative and payroll expenses you lose scheduling and rescheduling that appointment.
The revenue cycle for medical groups seems to get only more complex and difficult to manage.
In our Maximizing Your A/R series, we look at how medical practices can attack revenue shortfalls on more than one front. We already addressed how to use automated billing rules and track late payments to keep more of the money you earn.
In this third of three posts, we take on insurance underpayments.
It’s complicated. Follow up on medical claims from one payer in 30 days but wait to track payment from another for two months? What about that third payer that usually takes 90 days or more?
Trying to make sense of all these different payment schedules can be challenging. Beyond time-consuming, this complexity can cause well-meaning medical practices to lose well-deserved revenue. In fact, medical practices leave up to 30% of their reimbursement behind because they lack proper processes, training or technology, the Medical Group Management Association estimates.
Find an effective strategy in this second installment of our Maximizing Your A/R series (we covered getting more revenue with automated billing rules last time).
Let’s face it – keeping track of all those medical billing rules from different payers can be tough. And it’s not just the sheer number. Insurers keep changing the rules of the game along the way.
Technology to the Rescue
Many medical practices improve their accounts receivables with software that includes (and automatically updates) all those medical billing rules. This kind of software can help you catch potential denials before you send in your claims. Remember when payers reject a claim the first time around, the likelihood the practice will ever receive payment drops significantly.
The Medical Group Management Association (MGMA) found that better-performing medical groups average just a 4.05% claims denial rate.
Is your practice’s denial rate above four percent? If so, it could be time for a checkup of your internal claims processing. Manual errors, input oversights and timing issues create more denials than many practices realize.
Keep an eye on the following common reasons for insurance denials to see if you can tighten up your billing approach and lower your denial rate:
Before most large medical practices find the best electronic health record system for their needs, they research many choices and find some discouraging up-front costs.
However, the transition doesn’t have to be as complicated, costly and painful as it seems. Many medium to large medical practices find web-based EHR systems the perfect solution for their clinical and operational needs.