5 Signs Of A Failing Healthcare Revenue Cycle

Posted by Allen Ranjan on Jan 21, 2019 2:43:55 PM

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

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Topics: Effective AR Management, Revenue Cycle Management, Medical Billing Services Provider, Leading Medical Billing Company, Medical Billing and Coding

4 KEY STRATEGIES FOR EFFECTIVE DENIAL MANAGEMENT

Posted by Allen Ranjan on Nov 20, 2018 7:49:56 AM
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Topics: Effective AR Management, Accounts Receivable Management, Urgent Care Centers, Urgent Care Industry, Revenue Cycle Management, Medical Billing Services, Healthcare Revenue Cycle Management Services, Medical Billing Company in Orange County, Medical Billing Services Provider, Medical Billing and Coding

6 Tips to Optimize Medical Billing for Maximized Collections

Posted by Allen Ranjan on Nov 8, 2018 8:02:18 AM

The ever-changing healthcare landscape means the billers also have to continuously keep update their skills and concepts to stay on top of the changes and 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 and every claim should be 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 re-worked resulting in 5-7 % loss of potential revenue. When you have too many denials your revenue can pretty easily get locked in the Accounts Receivable and that can have serious impact to your cash flow.

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Topics: Effective AR Management, Accounts Receivable Management, Cosentus News, Medical Coding- Optimization, Contract Negotiation, Urgent Care Industry, Revenue Cycle Management, Medical Billing Services, Healthcare Revenue Cycle Management Services, Medical Billing Company in Orange County, Medical Billing Services Provider, Leading Medical Billing Company, Medical Billing and Coding, Medical Coding

4 Tricks For Creating Profitable Urgent Care Contract Negotiations

Posted by Allen Ranjan on Oct 17, 2018 1:07:38 PM

 

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.

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Topics: Effective AR Management, Contract Negotiation, Insurance Network, Urgent Care Industry, Fee Schedule, Revenue Cycle Management

Preventive Denial Management = Sustained Cashflow

Posted by Allen Ranjan on Oct 15, 2018 2:56:49 PM

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.

In this article you will learn 4 critical steps to implement preventive denial management.
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Topics: Effective AR Management, Accounts Receivable Management, Cosentus News

7 Key Elements Of Effective Accounts Receivable Management

Posted by Allen Ranjan on Oct 9, 2018 8:25:16 AM

 

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.

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Topics: Effective AR Management, Accounts Receivable Management, Cosentus News