Maximizing revenue for your medical practice

time to act

If you’re wondering at the end of every hard day of work where your private medical practice revenue is going, chances are that you may not be using an effective billing system. If your average medical practice revenue does not match the work you put into it, you’re not alone. According to TransUnion, 68% of patients end up never paying their medical bills. These were people with bills not more than $500, but that’s still a lot of lost revenue.

Times Are Changing

The era of easy in-office medical billing is long gone. For the past several years, the percentage of non-complying patients has soared. Many times, you’ll be required to provide care to an uninsured patient who needs expensive services done. With no insurance company to which you may turn and a person who cannot afford to pay for your services up front, what should you do?

Although patient compliance has decreased over time, you can use modern technology to your advantage with cloud-based and outsourced billing systems. You should expect to get the best results when you use this in tandem with a collections agency.

Increase Medical Practice Revenue

Between patients who do not pay for services and insurance companies that almost instantly deny claims because of medical coding technicalities, it might feel like you’ll never be able to recover your private medical practice’s revenue.

However, an automated system such as MedEffect’s may help you. Rather than waiting until a patient’s appointment time comes up, software like this can verify beforehand that the individual is covered. It can even ensure that your medical billing codes are correct before you get that dreaded notice from the patient’s insurance company that you will not be receiving compensation due to improper coding.

Automated software covers one base. However, software alone is not a complete solution in most scenarios.

How You’re Missing Out on Revenue

As we’ve discussed, insurance companies love to look for ways to cheat you out of money you’ve earned, and patients are less than happy to pay for services. As a practitioner, you probably don’t have the time to go after these issues. However, another agency may help.

With the assistance of a program such as MedEffect’s, you can drastically lower denied claims. Even when a claim is denied, you can configure such software to automatically appeal it. This may lower your denied claims to below 2%, helping increase your medical practice’s revenue.

If you’re still falling short of at least the average medical practice’s revenue, though, you may also need help with non-complying patients. Using an outside agency to collect your accounts receivable can work wonders. With the percentage of unpaid medical bills creeping up to nearly 70% in the United States, you can count on the majority of your patients not following through with their obligations. However, with expert collections agents and negotiators, you can help create payment plans that work for all your patients regardless of their financial situation.

The Synergy of Cloud Systems and Outsourcing

After taking a look at your bottom line and lost income, you will likely notice that your private medical practice’s revenue falls short of what it should be. However, with so many legal restrictions on how that money can be collected, you need to be careful with your interactions with non-paying individuals.

In order to increase medical practice revenue, you will likely need to rely on the synergy of software and real people. Especially if you have a smaller practice, this can be particularly difficult. Software on its own may help with coding and insurance companies, giving you some of the compensation you deserve, but it will not be a catch-all solution.

Collections agents will know how to legally approach your clients, following HIPAA rules and regulations. You won’t need to worry about lawsuits or malpractice issues as your billing issues are resolved. These agents can work with other financial institutions for a small commission. You can be instantly paid what you’re owed, and patients can be put on a payment plan.

Considering the effects of both of these elements, you should be able to substantially increase the likelihood of receiving the money you’re owed. This will probably also have a ripple effect as your medical practice would become known as one that aggressively pursues its rightful earnings via lawful means. Your practice would not be one for those looking to receive medical services without means of payment.

Staying Realistic

While all-in-one medical billing systems sound great, it’s important to ground your expectations in reality. There will probably be a certain percentage of income that is rightfully yours that never gets paid no matter how high in quality the billing system you use.

That being said, you should first look into your local average medical practice revenue statistics and compare your bottom line to that. Look at how many billed hours you have spent with patients, and determine how much money you actually receive versus how much money you should receive. Depending on your specialty and locality, you may be more susceptible to revenue loss.

The next step is to determine the source of the issue. It varies regionally, but it’s usually either due to poor choices of billing codes that lead to insurance rejections or patients not paying simply because they believe that they can get away with it.

The Rationale

You may be wondering whether it’s actually worth it to dive into all of this. After all, it seems like it would add complexity and potentially more time to your already busy schedule, right?

The answer is that it would likely not impact your practice as virtually all issues are handled by agents and software that runs automatically. Once you’ve determined what compensation you don’t receive on average, compare it to what you would get if the vast majority of your patients paid what was owed minus the small commission of billing software and what agents would take.

Chances are that your practice would end up with a higher profit margin, but you should definitely check out the numbers for yourself before committing to anything. Of course, there’s always a chance that you’re not missing out on much revenue, but it never hurts to verify.

After checking on your private medical practice’s revenue and comparing it to what it should be, compare it to the projected end result of using an all-in-one billing system such as MedEffect. We can set up a free practice analysis to determine what package is right for your facility.

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