In many practices, inefficiency causes a significant amount of revenue loss; reduction in reimbursements and rising costs are not the only factors causing financial problems for practices and hospitals. Some may even associate increased paperwork contributing to the loss of revenue, but this goes deeper than just profits and income.
How do practices lose money?
Having loss of productivity is a major concern for the practices. Lost productivity occurs when fewer patients are seen by the provider and fewer services are provided to the patients during their visits. Missing even one service can cost a practice a good chunk of money annually.
On the other hand, practices can lose productivity by having an excessive number of patients with unnecessary visits. This tends to affect the quality of the services and its complexity, creating loss of reimbursement. Also failing to provide services to the patients can also lead to loss in productivity.
How does inaccurate billing practices lead to loss of revenue?
Most common way that practices lose money is through inadequate or inaccurate ICD-codes. Many practices sometimes over code due to fear of penalties, while other practices depend fully on front-office staff and become the victim of under coding; resulting in delayed or denied claims.
Regardless of whether the inaccurate coding issues exist or not, making mistakes such as, not updating patients’ insurance coverage can cause delays in reimbursements. There can be more costs involved in getting additional labor to process the rejected claims.
Infrequent and improper fee schedules can also lead to loss of revenue. Sometimes fee schedules are not based on the resource-based relative value scale and are based on fees that are too high or too low. Therefore, just one low priced services could cost thousands of dollars to the practice each year.
Many practices do lack budgeting. Having a budget and comparing it to annual national surveys can help identify whether the practice is spending too much on staffing, office supplies, medical supplies, and other related things. Also maintaining the necessary supplies contribute to the expenses. There should be no occurrence of embezzlement or misuse due to lack of financial-control policies in place; which each practice should keep.
How to prevent these financial losses?
Prevention is the key to avoid the financial health of the practice. Some ways to prevent losses are:
- Set and try to achieve productivity goals.
- Enhance the provider/staff teamwork, and decide how the practice can optimize the patient flow.
- Technologies such as online referral authorization, phone-system automation, prescriptions, etc., should be updated and acquired by every practice.
- Determine alternatives to unnecessary patient visits. Uncomplicated issues can be managed via emails, phones, or patient portal.
- With the help of a scheduler, prescription renewals, mammograms or lab tests can be prepared.
- Be updated with new ICD-10 codes.
- Practices should familiarize themselves with proper billing practices such as processing new claims and follow up, confirming insurance coverage.
- Keep aligned with all the monthly charges, collections, adjustments and accounts receivable for unexplained changes.
- Check for unprocessed claims, appeals, and other pending bills.
- Establish a budget and always compare the income and expenditure annually.
- Adjust staff schedules to minimize overtime and develop staffing budget.
- Make sure that the staff obtains correct patients’ insurance information, preauthorization, service coverage, and notification.
- It is equally important to complete back-end work on time – bill holds, denial appeals and credit balance processing.
- Real-time reporting works better, that is – do not wait until last month to inform registration of failure in gathering the right data, which can result in claim denial.
- Confirm that the services will be reimbursed.
- Collect self-pay patients, as it does represent a fraction of all health care expenditures.
- Providers should accurately complete each patients’ diagnosis and clinical services performed.
- There can be a major impact on the practice’s revenue cycle, due to the constantly changing payor prerequisites for full reimbursement, as well as high turnover among patient access personnel.
Can customizing Psychiatry templates, save time and money?
Many practices using EHR are also using practice management software applications. Some EHRs are compatible or can be designed to be compatible, with an existing practice management system. It is important for the EHR to be able to communicate with the practice management and other technology as it is important for ease of use and interoperability.
It is crucial for all psychiatrists to meet the clinical documentation requirements. Psychiatry practices work at their best when using customized templates with respect to the user’s specific communication needs.
The only way psychiatry practice can face challenges using proper templates is when the EHR is leaning more towards mental health professionals and not psychiatry; this can lower productivity for small and solo practices, as they may not have the resources to make customizations as and when required.
Customizable templates allow the psychiatry providers to pre-select documents, to do initial depression evaluation, bipolar disorder evaluation, psychological evaluation, psychiatric progress note, eating disorder, depression, and anxiety, that can save the psychiatry practices time and money and also improve user satisfaction.
Practices tend to spend less time on administrative tasks and more time on patient care using leading-edge patient engagement tools. In just a few clicks, providers can maintain appointment scheduling. This reduces no-shows, and with the help of automatic appointment reminders, the practice increases take-home revenue. Eliminating manual entries and simplifying scheduling can also help psychiatry practice to grow.
Decreasing reimbursement and rising costs are not the only factors causing financial problems for the practices. Inefficiency causes a significant amount of revenue loss. As mentioned above, scheduling the appointment time effectively, by knowing the time required for different types of appointments helps providers to make more accurate use of their time.
Having a powerful psychiatry EHR can help the practices to manage processes and possess proficiency in collections, by eliminating duplicate data entry, reduce errors, and can pull data directly from clinical notes. Its connection to clearinghouse can accelerate processes such as pre-authorization and eligibility checking. It is important for all practices to be prepared and try to stop the loss of revenues.