Keys to profitable medical office management

Medical office management

Medical office management is becoming increasingly demanding as managers must cope with an avalanche of complex rules, regulations, and administrative processes. At the same time, costs are increasing while reimbursement rates are declining.

Health care providers are working harder than ever and are challenged with focusing on patient care—sometimes just to see a small increase in income. The only way for a practice to achieve financial health in this demanding environment is to operate at peak performance level.

There are some keys to optimizing practice performance and revenue, as detailed in these seven tips for medical office management:

  1. Figure out what you can and can’t do. Account for all the tasks your practice needs to perform to achieve financial health. Discern which tasks really need to be done by the practice and which can be shared with a practice management partner, freeing you to look at the big picture.
  2. Convert “lost” patient time into billable time. Optimize provider time by converting no-shows, cancellations and other “lost” time into billable time.
  3. Pre-process patients to ensure efficient, profitable appointments. Establish eligibility in advance to ensure a profitable appointment and reduce work downstream. Take advantage of payers’ online systems to establish patient eligibility and process claims, helping ensure you get paid what you deserve.
  4. Don’t let money walk out the door. Let patients know in advance of a visit what payment will be due, and collect deductibles as well as co-pays at the time of service.
  5. Bill appointments immediately and make sure claims are received. Most practices have significant charge entry lag, are in the dark about the accuracy of their claims, and are lax about clarifying what patients owe. Starting the process promptly results in cleaner data and, thus, fewer denials.
  6. Swiftly review and appeal denials and underpays. This requires vigilance and can be time-intensive and expensive, but systematic processes are needed for all claims eventualities: not hearing back from a payer, receiving a denial, when it’s time to bill patients for their charges, and when patients don’t pay.
  7. Track, benchmark and improve practice performance. Have tools to manage and monitor practice operations, and benchmark them against the performance of similar practices. Your practice management vendor should provide these tools, as well as an account manager who can coach you on how to take advantage of the tools to “step up your game” in each area of practice performance.
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