Medical practices may want to take a hard look at their own businesses to see where there are cash leaks. Specifically, are you collecting all your dues?
How do you know?
There is a safe way to find out. That’s by making sure you have an intense, monitored and unwavering quality assurance program (QAP).
In fact, this could be the most critical element for your practice when it comes to raising revenue. It forces all personnel to answer to an authority higher than themselves. The QAP provides an invaluable, non-judgmental report that can be used as a guide to improvement, further collections, and even procedural revisions that can make your practice more efficient.
Some points to explore in a QAP include:
Guaranteed all services are billed monthly. While this may seem too basic. It is not. The services of each day must be generated in a reserved and proportionate report. Next, generate a report of all unbilled services due to cancellation or other reason. This will increase billing because many facilities miss out on claim filing opportunities. Examples include a service that was simply “rolled in” or a missed treatment note.
Check the reasons for cancellation. If cancellations are the result of waiting too long, it may be time to adjust your business hours or add staff. If certain staff members have a higher cancellation rate than others, it may be time to review their customer service skills.
Examine your coding and reimbursement process. Find out if all codes are accounted for and each line item is paid. See if bills and provider claims have been submitted on time. You may also want to have two coders check each code to ensure accuracy.
Check refunds. Make sure you have looked to see if the payment has been received in a timely manner. If not, examine whether the items are being tracked and pressured for payment.
Check country zero. It is important to review zero countries because they could be the result of incorrect coding or insufficient documentation. They could even be due to improper insurance denials.
Overall, these five points, if properly reviewed in a QAP, can help your medical practice raise more money, adjust procedures, and discover ways to improve the business side of your practice. It is definitely worth spending the time to create a good QAP that is relevant to all of your staff.
