Practice revenue optimization is a central pillar in the running of successful ENT practice. Constant attention and fine-tuning of your practice is necessary in order to optimize and increase your revenues. Technology plays a key role in this process.
Here are three areas to focus on in optimizing your ENT practice revenues:
Eligibility Checks
With recent changes in the medical industry, more employers are seeking to share the burden of medical care costs with their employees through co-pays, deductibles, co-insurance and so on. For your otolaryngology practice, this means that everyone walking in the door potentially has a different healthcare payment arrangement from the last. If you have no immediate way of telling this, patients may be treated and leave without you knowing that they were to make certain payments upfront. Using technology to pre-verify all customers will allow your staff to know the deductible and payment status of each patient ahead of time. When implemented fully, this can have a massive impact on your revenues cycle in the short and long term.
Claims Scrubbing
Claims scrubbing refers to the use of technology to reduce insurance claim rejections and denials. Claims scrubbing software can has the following features:
- A library of criteria to boost “first-pass” claims success
- Has all appropriate CPT and diagnosis combination codes and details
- Incorporates payer rules engine that specifies codes and modifiers for each payer
- Integrates the EMR with billing to ensure details match before being sent out
- Checks that all payer required fields are filled out
- Can check for and catch underpayment by payers
Analytics
Demonstrating meaningful use is a big one these days. Owing to the pay-for-performance perspective adopted by government agencies, it is important for doctors to show how the tests and treatments they employ are actually improving healthcare for their patients. Analytics can help do this.
By tracking the evidence-based performance of all activities carried out in the practice, it is possible to demonstrate how your actions have improved a patient’s health over time. Analytics can extend into business processes as well, tracking how the different elements of your workflow impacts your revenues. For instance, through analytics, you can tell whether your new scheduling software has indeed shortened wait times and increased the overall number of patients you see in a day. You can also be able to track other elements such as claims vs. denials rate, AR rates over time and more.
By focusing on these three areas of technology, you can be able to effectively optimize your revenues and improve other aspects of your ENT practice.
