November 17, 2021 | By Scott Kraft, CPMA, CPC
A physician practice revenue cycle analysis is really driven by that old saying “Follow the Money.” Along the journey, however, we learn a lot more about payment buckets and accounts receivable, as important as those factors are for practice operations.
Very rarely do I perform a revenue cycle analysis for a client where I am not surprised by something that we uncover that creates a compliance risk for the practice.
That’s why I’m so excited to have the chance to discuss Conducting a Revenue Cycle Analysis to Ensure Compliance at the 13th Annual NAMAS Conference in Clearwater, Fla., from December 6-8.
We’ll talk about each of the “stops” along the way of the revenue cycle, including patient scheduling and check-in, pre-authorization, documentation, charge capture, coding, charge entry, claims transmission, payment posting, and denial management.
But we will do more than just follow the money. We’ll focus on the potential compliance risks that can pop up along the way, and how to spot and fix them. This definitely includes financial elements – making sure patients are charged the correct amounts, refunded promptly, claims are an accurate representation of services rendered and charges and write-offs are managed in a way that gives a meaningful, accurate snapshot of the practice’s overall financial picture.
A revenue cycle analysis is also an opportunity to assess the performance of the team to determine if roles and responsibilities are assigned in the best way and whether there is accountability to make sure each aspect of the revenue cycle process is being executed correctly.
This includes ensuring payments are posted correctly, that the documentation is defensible in support of what is being billed, that claims are being properly validated to ensure there are no coding errors and that practices are staying on top of regulatory and code changes before the impact shows up on the bottom line.
We’ll talk about the causes and implications of having accounts receivable balances that remain on the books longer than they should, the benefits of measuring claims denials and their impact on workflow and how to spot and correct errors. We’ll also discuss the importance of accountability in financial management and operations to ensure that errors and misconduct can be spotted and corrected before the financial liability overwhelms the practice.
I’m excited to see everyone in Clearwater in December to discuss this fascinating topic and answer your questions as they relate to the revenue cycle. Our goal is to make revenue cycle analyses productive and help you perform them consistently in a way that doesn’t seem overwhelming to staff, delivers results and fosters a culture of compliance. Hope to see you there!