10 Ways How Practolytics Can Maximize Your Practices’ Reimbursements in 2022?
Having a private practice is a lot of hard work. It often seems easy on the surface but the reality of it is much more complex. As a physician, you may want to focus on providing excellent healthcare to your patients, as you should. However, with a private practice that cannot be your only goal. There are many things that you need to keep track of, and the most important ones are claims management, reimbursement, and revenue cycle management. These tasks are not your responsibility per se, but ensuring that they are being performed regularly without errors should be your priority apart from patient care. After all, these are some of the most important markers of your practice’s success.
Table of Contents
Key concepts to keep in mind to improve claims management and reimbursement
Patients coming to your practice are covered by different payers and for smooth and efficient reimbursement, it is important to know the different plans they offer. Knowing these is especially important in the current environment where there is a huge change in reimbursements as a result of the change in focus from value-based care plans to volume-based care plans. The reimbursements are made possible after you file the claim, and making an error during this process could result in denials, costing your practice additional price. This may not be a lot with just one denial but if an error occurs once, it is most likely to occur again if appropriate steps aren’t taken to resolve the problem.
The most important thing you should train your administrative staff for is understanding the claims management process, with respect to the revenue cycle. This can improve your practice’s revenue significantly by facilitating reimbursements in a timely manner. Understanding claims management doesn’t just stop at understanding how to file a claim but also needs a thorough understanding of how different aspects of the patient’s appointment fit into the claim.
Simply put, your staff will need to think about claims from the moment a patient books an appointment. You will need to check prior authorizations and eligibility verification to ensure the patient is covered by insurance for the specific treatment being rendered. During the appointment, there has to be accurate medical coding performed and all clinical notes should be prepared accordingly, to reflect what was done to treat the patient and how it all fits into the claim. This is known as process integrity practice and it is extremely important to perform this process without any faults or errors. Only when these are complete can the billing process be started.
This is a sensitive process that can completely sabotage your profits even with the slightest error. It is often recommended to outsource the process to maximize reimbursements and facilitate the whole process. More often than not, private practices aren’t well equipped to handle this process and that can cost the practice a lot of revenue.
How Practolytics can maximize your practices’ reimbursements?
Practolytics provides a wide range of services that are aimed at facilitating each step of the billing and claims management process, with respect to the revenue cycle. We also offer revenue cycle management services which encompass most of what has been discussed above. Practolytics believes in using technology and automation to streamline the billing, coding and payment processes, ensuring clean claims and maximum benefits.
Let’s look at 10 ways of how Practolytics can help maximize your reimbursements.
Revenue Cycle Management (RCM)
Practolytics helps practices in maximizing revenue by providing new-age solutions to new-age problems, resulting in automation of the processes. Asking Practolytics to provide your practice RCM solutions is the best investment you can make for the sake of your practice. There is some level of financial commitment involved with the process, and Practolytics would also need access to your patient data. We analyze the data thoroughly and provide you insight into how effective your existing claims submission process is and where do you stand in terms of reimbursements from different insurances. All this is done under strict HIPAA compliance policies, making sure the data remains safe and secure while your revenues increase in a steady manner.
The best part of utilizing services from Practolytics is that you have well trained and highly qualified professionals working for your practice, while you save up on unnecessary costs of hiring trained staff or training your staff to perform these functions. Moreover, there is almost zero scope for error since Practolytics believes in automation and the rules are run by professionals at the top of their fields.
When thinking of outsourcing, many practices and healthcare professionals worry about the cost involved and whether it would be profitable for the business to outsource. They often think that the costs for outsourcing services are equal to the costs for covering the training of their staff. However, that is not the case as they often fail to consider the profits these services bring them. The facilitation of the billing process along with reduced errors, and lack of training fees increases profits and reduces overall costs to the point that the service pays for itself.
Less operational and technological costs
If you are not using the services of Practolytics, you are probably investing in the training of your staff which is an excessive cost given that errors are still occurring in your billing and claims management. However, these costs have already been discussed above. The other significant investment you may be making is technology involving practice management software and an EMR software or other types of software that are meant to make things easier for your administrative staff. However, these programs are only additional costs that can be collectively reduced by employing Practolytics, an all-in-one solution for your practice. We automate everything and provide you with necessary programs meaning that you do not have to invest in different pieces of software and hardware for each step of the revenue cycle.
Accurate medical coding
Medical coding plays a critical role in converting medical records into alphanumeric codes that are read by the insurance systems to complete the claims submission process. These medical codes explain the payer on what was done to the patient in terms of services and why the services were rendered. Using wrong medical codes or using them excessively, in a non-standard manner, could result in incorrect claims submitted to the insurances. This could be the reason for the denial of a claim and it is highly recommended that extreme care be taken to use appropriate codes and follow standard medical coding practices. Practolytics has a team of coding experts who review the records and ensure they are accurate and meet the insurance requirements for reimbursements.
Reduced mistakes and denials
Denials are the main enemy of your practice’s reimbursements. Each denial costs your practice. With Practolytics, not only are denials a thing of the past but they are also disputed anytime they do happen. In some cases, the denials by payers are not because of a mistake in the paperwork but rather a mistake in the filing system at the payer’s end. It is important to dispute the denials when this happens so that you are not repeating the whole billing and claims process as it will most likely get denied again. In other cases, the denial may be due to a mistake made by your administrative staff in paperwork such as incomplete patient information. With Practolytics, these mistakes just do not happen and when the payer makes a mistake, it is disputed and reimbursed. All of this happens with zero stress to you or your practice staff.
Advanced prior authorizations
It is important to receive prior authorizations for your scheduled patients to ensure that the services they need are covered by their payers. This reduces the risk of denials later on. One of the key services provided by Practolytics is prior authorizations which helps reduce any billing delays and unforeseen circumstances, hence, maximizing reimbursements for your practice.
Strict follow-ups for AR management
Accounts Receivable Management is a crucial indicator of your practice’s financial health and overall success. Practolytics aims to reduce these days so as to increase payments by following up with insurances and patients and sending reminders wherever necessary. Patient reminders are accompanied by different modes of payment through which the payment can be made, for increased convenience of the patient. Similar reminders are sent out to payers for the management of AR days with the main target being to reduce the number of AR days significantly.
Improved claim tracking
Tracking and following up on claims is important to see that the payers have received the claim and assessed it in a timely fashion. These follow-ups may be too much of a task for your administrative staff but Practolytics can easily automate the process. This allows claim tracking without requiring significant effort on anyone’s part.
State of the art EMR and Practice Management System
Electronic Medical Records and Practice Management System are important to ensure that the patient information, clinical notes, medical coding and claims submission are all accurate. Two important tools, out of many, provided by Practolytics are the EMR software and the Practice Management System which have two main advantages; your service doesn’t have to pay for these software tools separately and it keeps all your patient information up-to-date, further decreasing the risk of any mistakes. Charting and record keeping is made very simple and saves a lot of time for the providers, enabling them to focus on patient care instead.
The tasks that would usually be performed by your administrative staff can easily be performed by Practolytics. This directly saves you the costs of training your staff to do those tasks but it also frees up a lot of time for your staff. The administrative staff at your practice can then dedicate their efforts to patient and customer care, helping improve patients experience during their visit. The more welcomed and cared for the patient feels, the more likely are they to stay with your service, and even recommend it to friends. Freeing up your administration time to allow them to provide excellent pre and post-appointment care can be directly linked with increased patient retention.
With Practolytics, you get all services bundled into one package, helping you focus on the medical services rather than sitting on non-clinical work.
ALSO READ – How Does AdvancedMD Work and Its Benefits?