Just as a patient’s symptoms can be a sign of a more serious medical issue, the same applies to the health of your practice. In working with psychiatric practices for nearly 20 years, we’ve seen these signs many times over. The indications that a practice is not realizing its full financial potential can be clearly identified by looking at key metrics.
This guide covers some of these metrics, what they mean for your practice and how to address the underlying issues to improve your bottom line. Importantly, the challenges associated with each metric can all be improved with systems, processes and support staff that augments your internal team.
That’s what we do, as a dedicated partner to practices across the U.S., with software, services and consultative guidance. Our company is physician-owned, and we realize that managing P&Ls and software is not why you went to medical school.
1. Rejection Rate Reduction
Challenge: High claim rejection rates decrease your revenue and cause additional work in resubmission.
Key Considerations: Understanding the root causes of claim rejections, such as coding errors or inadequate patient data is vital. Regularly updating billing practices in line with changing regulations and payer requirements can prevent these issues.
How we help: We streamline the claim submission process, focusing on setup, eligibility, and coding-related issues. Our system methodically identifies and rectifies common causes of claim rejections, enhancing your billing department’s efficiency and boosting revenue.
Practices that streamline their claim submission process are able to reduce their rejection rates up to 75%.
2. Patient Collection Ratio
Challenge: Inefficient collection processes lead to lost revenue and extra follow-up work.
Key Considerations: Efficient patient collection starts at the front desk. Ensure processes and tools are set up to accurately capture eligibility and get payment prior to the visit. Clarity in financial policies and training staff to handle collections effectively are crucial. Implementing clear communication about patient responsibilities can increase upfront collections.
How we help: We optimize your patient payment process, ensuring that collections are maximized at the time of service. This approach minimizes the burden of outstanding balances and improves practice efficiency and profitability.
Practices with front desk virtual assistants are able to dramatically increase their collections. They expand their staff and accurately capture demographic info that leads to eligibility checks. When combined with a patient portal technology, the eligibility check prompts patients to make payment prior to the visit in the portal.
3. Insurance Aging Over 90 Days
Challenge: Delayed reimbursements from insurance companies impede your cash flow.
Key considerations: Timely claim submissions and effective follow-up strategies are essential to prevent aging of receivables. Regularly reviewing payer patterns helps in identifying and addressing delays proactively.
How we help: Our proactive approach ensures timely claim submissions and diligent follow-ups, keeping your claims from exceeding the 90-day mark.
Medical practices that keep diligent follow-ups on their claim submissions decrease their aging by 34% on average.
4. Maximizing Posting Amount
Challenge: Inaccurate or delayed posting can distort your practice’s financial health.
Key considerations: Accurate and timely posting of payments is crucial for a real-time view of a practice’s financial health. Regular reconciliation of posted amounts with bank statements ensures accuracy in financial reporting.
How we help: Our system guarantees that all payments are posted promptly and accurately, offering a clear view of your practice’s financial status.
Accurate and timely posting of payments allows practices 24-hour billing guaranteed.
5. Payment Mismatches
Challenge: Discrepancies in expected and received payments can lead to revenue leakage.
Key Considerations: Vigilance in tracking payments against contracted rates with payers is essential. Regular audits of payment entries can help identify and address underpayments or discrepancies.
How we help: Our team vigilantly tracks and rectifies payment mismatches, ensuring that your practice is paid correctly and in full for the services rendered. Along with accurate payment posting, our team ensures that your EHR system has the correct and up-to-date contracted fee schedules for each insurer and payer.
6. Complete Charge Capture
Challenge: Missed or incorrect billing of services rendered affects profitability.
Key Considerations: Ensuring that all rendered services are billed. Regular training for coding staff and providers on accurate and complete charge capture can prevent revenue leakage.
How we help: Our system ensures that all services are billed accurately and completely, leaving no revenue unclaimed.
By ensuring all services are billed accurately, practices increase their monthly collections by up to 43%.
The bottom line: managing the financial and operational aspects of a medical practice can be as intricate as treating patients. That’s where we come in, so you can focus on what really matters – patient care.
Psychiatry Cloud is a dedicated partner, not just a software provider, that helps improve all aspects of your practice’s operations, including Revenue Cycle Management (RCM) and beyond. Our services are tailored to meet the unique challenges faced by psychiatry practices. We utilize advanced technology in our telehealth services, we ensure impactful consultative guidance in our Reputation Management services, and we deliver data-driven insights in all our services to measurably improve the efficiency and financial health of your practice.
What are Your RCM Metrics?
Get a Complimentary Assessment.
The Psychiatry Cloud Advantage
Revenue Cycle Management Report Card: An insightful overview of your practice’s performance in Revenue Cycle Management and beyond, with data-driven insights and action plans for improvement.
Comprehensive Service: From goal setting and onboarding to dedicated account management, practice health reviews, regular check-in meetings, and full staff training, we’re with you at every step.
Beyond Software: We are a high-touch partner, deeply invested in your practice’s success. We help you build your reputation and brand online, we take over administrative tasks so you won’t have to, and we deliver solutions to help you with patient communication. We do for you what we do best so you can focus on what YOU do best: patient care.
