Many medical practices are having a tough time sustaining and improving their performance and practice revenue as the healthcare environment continues to involve. Trying to juggle decreasing resources with increased provider and patient demands makes it difficult to keep practices growing financially. While aligning with hospitals and health systems through affiliate or employment arrangements can be financially beneficial to some medical practices, but it doesn’t ensure optimal performance, growth, or improved practice revenue. 

How can you make sure your practice doesn’t sink? What can you do to start bringing in more revenue? The first step is to understand the obstacles standing in your way and then address them to start seeing growth and improvement.  

#1 Not Cultivating Good Referrals 

If you’re not securing and cementing quality referral relationships with other physicians, you’ll find it difficult to improve practice revenue. A significant portion of your patients will come through referrals, and so you must work on building relationships with the doctors most likely to send patients your way. 

What can you do to ensure that other physicians are sending medical patients to your practice? Here are a few things that help: 

• Get to know other physicians in your community. According to Medscape, less than 10% of doctors will refer their patients to a physician they don’t know. This means you need to get out there and build relationships with other doctors, whether it’s by getting involved in community events, speaking at seminars, or taking time to reach out to local PCPs. 

•  See referred patients quickly. Referring PCPS will be aware of any delays in getting their patients seen. 

• Treat patients well. PCPs will take complaints about providers very seriously. Offer patients the best treatment, and you’ll increase your likelihood of repeat referrals from that PCP.

• Make sure you report back quickly. Email and fax offer fast ways to get the results back to the referring physician. If it’s a referral from a new source, it’s always a great idea to call the referrer in acknowledgment. You can thank them and discuss how they’d like to receive your reports.

#2 Failure to Keep Operations Efficient  

Failing to keep practice operations efficient can result in loss of revenue. Quality of care and efficient operations must work together to improve performance, growth, and profit. Having a skilled medical practice manager in place can often help ensure that major problems are addressed. Some of the key tips for improving operations efficiency include: 

• Tip #1 – Schedule Patients in a Way that Maximizes a Providers Time –  Specialists like cardiologists have complicated call schedules and extensive outreach time, so it’s essential to take measures to maximize the time of each provider. Along with careful scheduling, it’s important to monitor the schedule of each physician to ensure the practice is covered appropriately all the time.

•  Tip #2 – Ensure Proper Staffing at the Office and the Hospital – If your medical practice works with a hospital, it’s critical to make sure that both the clinic and the hospital are adequately staffed. Understaffing or overstaffing can be both be big problems for medical practices and affect the revenue cycle.

• Tip #3 – Monitoring Performance – Performance dashboards allow medical practice managers and providers to monitor important metrics like staffing expenses, days claims spend in collections, number of referrals, or the number of claims denials. Keeping track of performance and sharing the results can make it possible for changes to be implemented that improve operations efficiency, boosting the bottom line. 

#3 Inefficient Billing and Coding

Inefficient billing and coding can also keep a medical practice from seeing the increase in revenue their practice needs. Some of the billing and coding challenges that present themselves in the medical specialty include: 

• Difficulty Staying Updated on New Codes – Specialities like Cardiology, Orthopedics, Pain Management, Nephrology  codes change continually, and it’s often difficult for practices to stay updated on the latest changes. If you use in-house coding staff, make sure you have the current ICD-10 CM and PCS, HCPCS, and CPT code books on hand. Coding personnel should also refer to the CMS website regularly for the most recent updates. 

• Failure to Provide Accurate and Complete Documentation – When documentation problems occur, it slows down your entire revenue cycle, leaves room for inconsistencies in coding, and decreases your billable expense reimbursements. This can be especially tough for procedures. Any documentation gaps for procedures can result in the loss of codable components and potential codes. Changes in a procedure can always occur, so it’s essential that providers provide thorough and complete documentation to coders. 

• Not Coding to the Highest Degree of Specificity – Failure to code to the highest degree of specificity can result in lower reimbursement. Providers need to chart all relevant chronic and comorbid diseases completely. When possible, providers should document the diagnosis, not just the symptom. Charting to the highest degree of specificity possible is critical, too, such as diagnosing diastolic or systolic congestive heart failure compared to unspecified congestive heart failure. The difference diagnosis code can impact the way care is graded or reimbursed, so coding to the highest degree of specificity has a direct impact on practice revenue. 

For many medical practices, inefficient billing and coding results in reduced revenue due to claims denials and time spent reworking denied claims. The easiest way to find out if you have inefficient medical billing processes is to look at your account receivable and claim adjustment report. Please call us at 770-666-0470 for quick no-obligation free medical billing and coding audit.

Some practices choose to prevent this problem by outsourcing their medical billing and coding. If your practice is looking for ways to improve efficiency, reduce claims denials, and ultimately increase practice revenue, we can help. M-Scribe offers professional billing and coding services and fully understands the unique challenges that come with medical coding. To learn more about how we can help your medical practice enjoy fewer denials, higher reimbursements, and a boost in practice revenue, contact us today for more information.

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