Maximizing Your Medical Practice Revenue and Profit in the Home Stretch (Part 1 of 2)

Laurie Morgan August 13th, 2012

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Now is the time to set your medical practice revenue up to make the most of the homestretch

2012 is now more than half over.  Many practices have their biggest revenue opportunities in the last few months of the year – so, now is the time to set your practice up to make the most of the home stretch.  If your medical practice revenue tends to be a bit slower in the summer, use some of that downtime to get ready for fall. 

Start with revenue analysis.

Dig into your practice’s data while you’re less busy – and take corrective action.  Some things to look at:

-       Denials. The quickest path to getting more revenue is to stop losing it; expend less effort collecting your revenues, and you’ll also immediately increase profitability.  Analyze denial codes for patterns you can correct.  Often, the reason for denial starts before the encounter; e.g., names and addresses that don’t match, missing preauthorizations, or terminated coverage.  If errors are happening at your front desk, now is the time to make sure everyone is fully trained on their role in the revenue cycle!  Also look for provider patterns – to determine if, say, one provider in your practice is consistently miscoding or not providing adequate documentation.

-       Receivables analysis. Ballooning receivables provide false security by suggesting that large sums of money will materialize “eventually.”  In reality, receivables that go past 90 days are unlikely to be collected – especially if you try to do it yourself.  Now is the time to develop a clear-cut policy on handling patient receivables – including outsourcing appropriately.

-       Contract review.  Are you always getting paid the allowable amounts based on your contracts? It’s not uncommon for payer errors to short-change a practice consistently for certain codes – say, because of a system error on the payer’s side.  A loss of even a few dollars on an important code can cost your practice thousands over the year – on the flip side, sniffing out such an error is like finding free money!  It’s especially important to do this before your volume increases.

-       Payer review.  Have contracts that are expiring this summer?  This is the perfect time to eliminate unprofitable payers and strengthen your ties with your most important payers.

Improve utilization.

Many practices have a natural increase in volume starting in the fall – and, in Part 2, we’ll share how to capitalize on the trend by marketing to bring in more patients.  But, to maximize the benefits of the busy season without sacrificing patient service, you’ve got to be ready to handle more volume efficiently. Here are some ways to start preparing:

-       Scheduling.  Providers should be fully booked each day they’re in the office.  Gaps in their schedules mean no revenue can be collected while all expenses are still incurred.  Be sure your appointment staff is trained to offer patients the first appointment available, instead of asking, “When would you like to come in?”

-       Staff overtime. Review your overtime expenditures for the first few months of the year.  If one or more employees are consistently earning overtime, that’s a red flag – and a bite out of profitability.  If your practice consistently pays overtime, you may need to add staff to fill the gap.  Adding staff costs less per hour than overtime – and, your new members will be contributing their most productive hours, rather than trying to do more work while already tired from a full day.

-       Seasonal provider staffing.  Many practices could profitably operate weekend and evening clinics during the fall and winter, but hesitate because providers don’t want to work those hours, or because they’d need to pay overtime.  When mid-level providers can handle the patient load off-hours, PRN staff can fill these roles without breaking the bank; develop a relationship with one or more local agencies and/or with particular providers who are interested in working these unpopular hours.

-       Technology. Too many practices have partially implemented EMR and practice management systems.  Often, inadequate training is to blame; use extra time in the summer to bring everyone up to speed on the tracking and reporting capabilities of your systems.  When everyone is fluent in your systems, and using them to capture patient data religiously, the value of the systems increases enormously.  (We’ll take a look at using that data in Part 2.)

Coming up in Part 2:  Developing new services and using marketing to maximize the busy season.

Laurie Morgan is a management consultant with Capko & Company. She specializes in marketing, management and technology for medical practices and blogs about practice management issues at Laurie has a BA in Economics from Brown University and an MBA from Stanford. Laurie recently wrote for Getting Paid on ACA Is Upheld: Will Medicaid Be Your Next Payer?, Staying on Top of Business Trends to Protect and Build Your Medical Practice, and My Receivables Are Growing: Time for a New Billing Service?

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