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Using Analytics Tools to Identify Revenue Leaks in Medical Practice – Part 3

February 19, 2018

Analytics Tools to Identify Revenue Leaks

In previous blogs, we took a look at some of the more common ways practices lose money. Front desk omissions and errors, billing mistakes and unread/ misinterpreted EOBs are among the most common, but even when a practice conscientiously tracks its revenue cycle, whether manually or through its EHR system, errors and gaps can occur. Here are a few ways to find and fix them as we tie this information together with the previous blogs.

Use analytics to know who is impacting your revenue cycle

Use of analytics tools are perhaps the most important aspect of the art and science of revenue management regards to identifying a sources of lost, or revenue leaks in medical practice. Analyzing performance on a regular basis can pinpoint gaps in benchmarks as well as enabling factors in the following areas: 

        ·  Front desk

Incorrect or missing patient intake information at the time of an appointment can cost thousands in denied claims, something that analytics can confirm. Be sure your front office staffers are taking care of these important details.

  • Billing and back office

Analyzing EOBs as part of managing denials will reveal whether transmitting incomplete, duplicate or incorrect claims may be causing denials resulting in lost revenues as well as help determine essential productivity standards.

  • Providers

It is the provider’s responsibility to correctly use codes and modifiers. While challenging due to the hundreds of CPT and ICD-10 codes, analytics can show which codes are problematic.

  • Collections

Analytics can be used to review and evaluate the practice’s debt management procedures as well as patient-responsibility guidelines.

Comparing other groups and practices through analytics and other information from organizations such as the Medical Group Management Association (MGMA) and Healthcare Billing and Management Association (HBMA) are good sources of industry data and surveys. Third-party billing and practice management organizations may also be able to offer comparison data as well as reporting. These services may be able to provide data analytics, data mining and digital dashboards for real-time tracking and measurement as well as alerts when problems occur.

Ideally, your EHR’s comprehensive system includes reporting with data analytics, as well as offering compatibility with all other data sources, helping your to correctly identify and remedy billing issues promptly. Reports based on accurate and current data provide the practice the ability to make sound, informed decisions regarding workflow and optimum use of resources.

Because provider reimbursement is a multi-faceted undertaking, without revenue cycle management working in tandem with the latest business-intelligence tools, the practice’s ability to accurately identify trends impacting revenues will become more difficult.

Knowing when to outsource your revenue cycle

There are three main factors for consideration in deciding whether to outsource the revenue cycle:

  • The practice’s staff competence levels in fee billing, including accuracy and timely output
  • The adequacy of the practice’s EHR and/ or billing systems
  • The ability of both staff and technologies to expand with the practice’s growth

If at least two of the above factors exhibit weaknesses that can’t be quickly remedied, outsourcing is probably the best choice to avoid falling behind in billing and revenue capture. Other factors may include in-house billing costs that are higher than benchmarks or collection rates have dropped.

Partner with a trusted, experienced practice management company

M-Scribe’s senior accounts receivable (AR) specialists can perform a comprehensive in-depth analysis of your payer-specific coding and billing denials. Once done, M-Scribe will work to collect the monies due your practice, while developing and implementing solutions to prevent future denials. Using historical data as well as reviewing your contractual agreements will help to measure the efficiency of procedures over time as well as payers. Contact M-Scribe at 770-666-0470 or for a free analysis of your practice’s needs and revenue goals.


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