Is your medical practice ‘buttoned up’ ?

I work with medical practices all the time, and they don’t always seem to have all their bases covered.  This means they are spending their days fighting fires, while they provide patient care, but they are not able to spend their time proactively thinking about how to make things better.

Here are some questions you should ask yourself to see if your medical practice is performing at the top of your game:

1. Do you have command of your numbers?  And do you know what those numbers mean?  Between your accountant, and your practice management and billing systems, you should be able to know all kinds of metrics about your practice.
2. Do you know where your patients come from, and do you know which patients you’d like to have more of?  Less of?
3. What is your internet presence, and what do patients who are looking for your services, or looking into your practice, find when they do a search?
4. Are your contracts and fee schedules all up to date, and have you negotiated the highest reimbursement from your payors?
5. Are all your forms, superbills, EHR templates, billing reports up to date so you can maximize your capture of the most current documentation, coding, billing and remittance information?
6. Are you providing only those services you’ll get paid for, and referring patients to other specialty providers when their insurance plan won’t pay you?  For example, many insurance companies today don’t pay for imaging services in the office and require patients to go to specially contracted imaging centers.  Many providers have the equipment and figure it doesn’t really cost more to do it themselves, however, have you really done a return on investment analysis?
7. Are you documenting and coding and billing correctly for all the services you DO provide?  Many providers are so wary of being accused of over billing or over coding that they are cheating themselves.
8. Are you getting paid, and paid correctly, for all services you do provide?  If you use an outside billing service, how do you keep track of this?  What do you do when reimbursement falls short?
9. Do you perform regular internal audits of your entire revenue cycle to identify any areas in need of improvement?
10. And, this is a new one over the past couple years.  Are you KEEPING the payments you do get?  Every insurance company, especially the governmental payors like Medicare and Medicaid, have hired outside firms to work on a CONTINGENT FEE BASIS to identify ‘fraud and abuse’ and recover payments already made to providers, and many times these are for services provided YEARS AGO!  These companies cast a wide net looking for any potential discrepancies and many providers are so afraid of getting onto the radar of the government in any way that they may actually be doing themselves a disservice by not assertively responding to these refund requests.

 

I met with a practice yesterday that had met just about all these criteria, and it was so refreshing!  With so many practitioners being challenged by all the change going on in the healthcare arena, it is inspiring to see that it isn’t getting to everyone.

How about you?  If your practice needs a tune up, or if you’d like an assessment of the most cost effective improvements for your particular practice, contact us for a free consultation at info@HabaneroInc.com