Identifying Opportunities for Improvement in Your Health Care Practice

On average, doctors spend two-thirds of their workdays filling out paperwork, which restricts the time they spend with patients. This is largely a result of health care regulations, which make it time-consuming for doctors to enter orders into the system’s computer and can be more efficiently managed by administrative staff.

Ultimately, identifying problems within the workflow is the first step in improving employee productivity. Your practice can evaluate how various factors are contributing to or hindering a streamlined workflow by assessing the following processes.

Process #1: Billing and Collections

 First, review your billing and collections procedures. Due to more stringent documentation requirements, it can be difficult to collect payments from insurance companies and patients. An increasing number of patients are now responsible for a portion of their medical bills, which makes collections even more challenging.

To ensure financial success within billing and collections, keep in mind these best practices:

1. Shorten your billing cycles to improve collection rates. The majority, if not all, of your practice’s medical claims should be billed electronically. Electronic claims typically process in seven to 10 business days, whereas paper claims can take up to 30 days.
2. Filing electronic claims will also allow your staff to quickly check a claim’s status in two to three minutes online. This way, your staff won’t waste time on hold with an insurance company.
3. To avoid future revenue delay or loss, your practice should make a point to identify the causes of underpayments and denials. This includes making sure any claim denials are resolved in a timely fashion.
4. All accounts receivable (A/R) should be worked from the highest dollar to the lowest. Doing so will result in overall lower accounts receivable days, meaning your practice can collect more money in a shorter time period. Collectability is key to profitability and the more time passes, the less likely payment will be received.
5. Inform patients of their liability. This can be done either in advance or as soon as possible after providing service. Insurance companies are shifting more of the burden onto patients to pay out-of-pocket for a portion of their medical expenses, and upfront communication can minimize the sticker shock when opening a bill.

Process #2: Front Desk Tasks

 The second area to consider is how efficiently the front-end staff performs their regular tasks. Revenue cycle management begins with clearly defining staff responsibilities and holding them accountable. Streamlining the management process by training staff and implementing a system of checks and balances in the billing department is an instrumental step in resolving billing inconsistencies and poor follow-up. The revenue cycle of a patient account originates as soon as the patient’s demographic information is entered. Without accurate information inputted, payment can be delayed.

Does your practice have a high rate of no-shows? In other words, does your front desk staff deal with a large volume of patients who reschedule, cancel, or don’t come to their appointments? If so, online patient scheduling can reduce no-shows. The biggest money maker in a practice is keeping exam rooms full, giving patients the freedom to manage and schedule their own appointments will likely lead to improved efficiency for the entire office.

Process #3: Documentation and Coding

 Assessing the area of documentation and coding at your practice is another essential factor of a streamlined workflow. Is every patient’s chart compete, accurate, and in compliance with coding standards? In order to efficiently manage claims and receive payment, proper documentation and coding are indispensable.

If your practice is still using a paper-based charting system, it can be useful to switch to an electronic health record (EHR) to improve accuracies and save costs. It is also advisable to clearly specify the correct assignment of codes or diagnoses, which are needed for compliance and reimbursement.

Do all of the job areas in your office contribute to workflow success? To operate at optimum efficiency, your practice must establish well-developed billing, collections, front desk, documentation, and coding processes that are driven by each staff member.

Do you have questions about improving the efficiency of your health care practice?

Please contact the Healthcare Group in our Accounting and Consulting Department at 214-871-0011.