Revenue Cycle
Revenue cycle management includes tracking claims, ensuring payments are received, as well as follow up on denied claims to maximize revenue generation. Several metrics tools exist to help you determine whether your revenue management cycle processes are efficient and to achieve your desired results. Understanding your practice’s revenue cycle will help you anticipate income and address issues preventing timely payments. Keep the following in mind when evaluating your revenue cycle and accounts receivable A/R processes:
- Slow-to-pay carriers
- The impact of credits
- Accounts in collection
- Appropriate treatment of payment plans
- Claims that have aged past 90 or 120 days
Benchmarking
Benchmarking is a process of measuring key performance indicators and comparing them with national averages and produce better performers. Benchmarks allow practices to answer the question, “How are we doing?” Benchmarking includes:
- Percentage of A/R > 120 days
- Days in A/R
- Gross Collection Rate
- Net Collection Rate
- Credit Balance % of A/R
Credentialing
Medical Billing Solutions of Charleston, LLC has extensive experience with Council for Affordable Quality Healthcare (CAQH) registration. Our team can enroll your practice with all the top payers in your area including government, commercial, and managed care plans. We work closely with you and your payers to eliminate any delays and expedite your enrollment process.
Contract Management
Managing payer contracts
Managing contracts is another missed opportunity for medical practices. It is important to keep track of every contract. If practices are not tracking their contracts, it is impossible to know when the practice is being underpaid. Practices need to compare the actual payments received against the payments specified in each payer contract.
Internal Control and Assessments
In every medical practice there are a couple of areas of utmost concern when it comes to Internal Control: patient income and disbursement/payables. These items are imperative for running an effective medical practice.