Your net revenue cycle is a ‘nervous system’ of signs, symptoms and conditions
AS DOCTORS AND CHIROPRACTIC ASSISTANTS, WE COMMUNICATE TO OUR PATIENTS how interferences in their nervous system are often a cause or contributor to physical signs, symptoms, or more problematic and severe conditions they may be experiencing and seeking care for. We educate our patients that if these interferences are untreated and unmonitored, the effects can become more severe, take more time and treatment to improve or repair, and even be the source for new potential signs, symptoms and conditions that didn’t exist before.
However, with routine valuation and appropriate care, these signs and symptoms are minimized or eliminated, and more challenging conditions are improved or sufficiently managed — which allows the patient to function more optimally and free of, or with minimal, nervous system interferences.
Your practice’s ‘nervous system’
I believe that the outstanding care chiropractic practices render to their patients makes up the “heartbeat” of the practice, if you will. After all, without patients, there is no practice. To use a similar analogy — in my view, the revenue cycle system is essentially the “nervous system” to the practice. In other words, interferences in the revenue cycle system are the result of numerous signs, symptoms and conditions related to practice cash flow, collections and even time management.
Sometimes those in charge of billing and collections didn’t even realize that was going to be their role when they were hired. They have limited to no understanding of coding requirements, what’s necessary for clean claims and submission, how payor policies and network requirements apply, the necessity of state law knowledge for both insurance and self-pay patients, and the list goes on. Often when asking why something is done a certain way, I am told, “We just do it this way because that’s what we’ve always done.”
In this scenario, CAs often feel a lack of confidence in their own performance, and perhaps even know that there are missing pieces, but have nowhere to go with questions and concerns. The result: billing-and collections-related errors, uncertainty in what or how to communicate with patients about finances, loss of practice money and time, sometimes higher rates of staff turnover, etc.
Interference: Lack of understanding of the revenue cycle system
The revenue cycle system is quite complex — far more than simply just billing and collecting.
Consider the following components: insurance verifications, electronic and paper claims, federal payors, Personal Injury and Workers Comp. payors, patient financial communications, over-the-counter collections, rejection management, claims processing and posting, in-/out-of-network guidelines, patient invoicing, non-covered or alternative treatment procedures, correct coding, claims review and posting, self-pay patients, appeals, follow-up and aged receivable management, etc.
This limited list of revenue cycle system components often brings to the surface many questions and concerns that practices have in one or more of these areas. It is very easy to get stuck in the daily mechanics of data entry and billing while many of the crucial components to the net revenue cycle system are set to the side, forgotten about, or never even fully understood.
Interference: Time management challenges
There are so many hats most CAs in a practice wear on a day-to-day basis. Even the most talented CAs can find themselves constantly playing catch-up and with a growing to-do list that there never seems to be time for.
In this scenario, it is often those net revenue cycle-related tasks that may be more time-consuming that are set to the side and left unattended.
Interference: Insufficient billing, collections and accounts receivable systems
Unattended or poorly attended systems will result in a growing restriction of cash flow. The older the balance (from patients and payors), the more difficult it becomes to collect and the more costly it becomes to the practice. Motion is a sign of life — water, air, blood and even cash flow. Stagnant monies in billing, collections and accounts receivable systems have many long-term effects to a practice.
These interferences minimize growth, expansion, workforce confidence, efficiency, patient relationships, practice overall value, financial health and more.
Net revenue: implement a corrective plan
In my office I work with practices every day to help identify and remove those net revenue cycle systems interferences. In some cases, practices are aware of where interferences are occurring but need assistance to establish necessary action steps for a productive and manageable path forward. In many other practices, we often are able to identify unknown interferences that may have been restricting cash flow for months or even years.
In most practices these interferences are generally found to be in more than one area and prioritizing a corrective action approach can be daunting to a practice. The good news is that improvement and correction are possible for every practice. The great news is that by properly evaluating and implementing a corrective action plan for your revenue cycle system, the stifled cash flow, compliance vulnerabilities, time management challenges, and other symptoms or conditions your practice is experiencing, they will either diminish or disappear completely.
Additionally, moving forward, your practice will be able to identify new interferences more quickly as they occur and be better prepared to address them promptly with confidence.
Consider your own practice net revenue cycle systems interferences, as well as the related symptoms and conditions you may be experiencing as a result. Right now is always the best time to take a proactive approach to evaluate and remove revenue cycle system interferences. Freeing your practice of those restrictions that are costing you time, confidence and money will ultimately improve the overall function of your entire practice.
BRANDY BRIMHALL, CPC, CMCO, CCCPC, CPCO, CPMA, can be reached at sidecaredge.com.