At Cosentus, we often sign new clients who have a very messy accounts receivable. Sometimes these clients will tell us that they are barely able to stay afloat, as their medical billing company has not been billing their charges out or they do not refile claims or work denials. These troubled practices are only able to notice the lack of performance once their cash-flow has been negatively impacted. However, in our experience, there are predictable signs of an upcoming crisis thatoften start a good 6-8 months before your cash-flow is disrupted. In this day and age, you must outsource your billing, but alsoreview the performance of your medical billing company every now and then to make sure they are doing their expected job.

Often times, medical practices are not even aware of any problems in their revenue cycle management until they begin to lose money. Most times the practice administrators will want to ask questions or review the performance of their billing service, but do not know the right questions to ask and are not aware of how to investigate and ensure their revenue cycle is being managed efficiently. Cosentus has put together a list of 5 warning signs to watch out for, along with the right questions to ask your billing service. 

Download free checklist- The Ultimate AR checklist

Cash flow is the lifeline of any business, and an independent medical practice is no different. As a practice owner or administrator, the best way you can ensure consistent and increasing cashflow is by preventing your revenue from being locked in denials. Management of denied claims is important and will remain so, but the main focus needs to shift from management to prevention. The benefits of this shift are immense but so are the challenges of eliminating the traditional retroactive approach. 

According to industry sources, 90% of all claims denials can be prevented. However, for this preventive mechanism to work and deliver optimal results, all departments in the revenue cycle need to collaborate and work cohesively. Once you have seamless & effective practices implemented throughout processes such as patient access to claims submission, you will reduce your future denial rate by 50-60% and enjoy sustained cashflow. 

In this article, you will learn the 4 critical steps required to implement preventive denial management. 

The ever-changing healthcare landscape means coders and billers also must continuously update their skills and concepts to stay on top of the changes to make sure they are not leaving money on the table. With the introduction of EMR and advanced practice management software, the general belief is that the standards of billing and collection will be like never before - with every claim being billed out accurately and collected upon in a timely manner. Unfortunately, according to industry sources, independent medical practices are still leaving as much as 30% potential revenue on the table due to the inefficiencies in the billing and collection process. This happens because the rejection and denial rate is still too high and almost 50% of denials never get worked resulting in 5-7% loss of potential revenue. When you have too many denials your revenue can quickly get locked in Accounts Receivable creating a serious impact to your cash flow.

Cosentus is a leading medical billing service provider having optimized the billing and collection processes for numerous practices, enabling them to maximize their revenue and get rid of their cash flow issues. The purpose of this article is how you can implement these basic changes to your existing billing process and see your revenue grow by 25-30%.

At Cosentus we often sign new clients with their accounts receivable in a total mess. Sometimes these clients will tell us that they are barely able to stay afloat, as their medical billing company has not been billing the charges out or they do not refile claims or work denials. These troubled practices are only able to notice the lack of performance once their cash-flow has been badly impacted. However, in our experience there are major signs of an upcoming crisis and these signs can start a good 6-8 months in advance before your cash-flow is disrupted. In this age and time, you got to outsource your billing, but you need to review the performance of your medical billing company from time to time, to make sure they are doing the job, they were expected to do. Often times, medical practices are not even aware of any problems with their revenue cycle management, until the money starts drying up. Most times the practice administrators would want to ask questions or review the performance of their billing service, but they do not know the right questions to ask or are not aware how to investigate and ensure their revenue cycle is being managed efficiently. Cosentus has put together a list of 5 warning signs to watch out for, this article will provide you the right questions to ask your billing service.

Download free checklist- The Ultimate AR checklist

Negotiating profitable contracts with Insurance carriers is critical to the success of urgent care centers. However, considering that Insurance companies constantly want to reduce their costs, this is easier said than done. The key is letting the insurance carriers know how by paying you more they are still going to save cost. We recommend you try these 4 tricks, if done right, these steps will help you negotiate the best reimbursement from the insurance.

Cash flow is the lifeline of any business and an independent medical practice is no different. As a practice owner/ administrator the best way you can ensure this, is by preventing your revenue from being locked in denials. Management of denied claims is still important and will remain so, however the focus needs to shift from management to prevention. The benefits of this shift are huge but so are the challenges of eliminating the traditional retroactive approach.

According to industry sources 90% of all claims denials could be prevented. However, for this preventive mechanism to work and deliver best results, all departments in the revenue cycle need to collaborate and work in cohesion. Once you have cream of the crop practices implemented throughout the processes from patient access to claims submission, you can reduce your future denial rate by 50-60% and enjoy sustained cash-flow.

Table of Content

                             Overview

                      Key#1 Code It Right

                      Key#2 Submit Clean Claims

                      Key#3 Correspondence Is For A Reason

                      Key#4 Effective Denial Management

                      Key#5 Payer Contract Enforcement

                      Key#6 Stick to the Follow up Promises

                      Key#7 Stay on top of your Credit Balances

Overview

Arguably the trickiest piece of the puzzle, Accounts Receivable Management is the holy grail of RCM business. With everything that can be done to send out the cleanest of claims in a timely manner, the insurance would still deny a whole bunch of them for a variety of reasons & it takes skills, understanding & expertise with a consistent ability to keep working on them to resolve such claims. The ever-so-changing healthcare landscape has more dynamic forces working right now, with the ICD-10 in place and several looming changes to the Medicare, Medicaid, and the CHIP plans .

As a result, the Accounts Receivable for an independent practice keeps growing but the reimbursements keep shrinking. According to industry sources most practices, unfortunately, leave as much as 30 % potential revenue on the table. The onus of providing the best care to the patient is demanding & on top of it the pressure of converting the AR into cash flow makes it far from ideal. Payer policies around coding, payer contracts, denials, correspondence coming from the payer they all need to be accounted for to make sure the AR is within the control and the cash flow is optimized.

Per some industry estimates, many leave an average of 25 to 30% money on the table. According to industry sources, this happens because almost 50 % of denials never get re-worked resulting in a 5-7% loss of potential revenue. The primary reason being the lack of time & knowledge to effectively dispute this. Not to mention the cost to collect on these claims & it can add up fast.  

In this white paper, you will learn how by incorporating some industry approved best practices you can stay on top of your accounts receivable and optimize your collections with the potential of up to 25-30 % additional revenue.