There are many challenges that can interrupt your practice’s cash flow, some of which are common enough you almost come to expect them as part of the process. But this doesn’t have to be the case.
The billing challenges you face can be identified and improved upon to make sure your practice gets paid in a timely manner. At Curas, we’ve learned where to look for the top billing challenges practices face, and how to best rectify them.
Every denied claim is due to some sort of error, and every denial means a delay in payment for you. Claims can be denied for a variety of reasons, including:
- If the claim is missing or has incorrect information, such as patient demographic data or provider billing data
- If they do not have a referral from a primary care physician or required prior authorization for the service
- If the patient was ineligible for the service they received
- If the claim is not filed in a timely manner.
Not submitting claims
No one intentionally forgets to submit claims, so you may be surprised to discover that you have a backlog of encounters that have yet to be billed. Unbilled encounters (e.g. progress notes not locked or hospital charges not entered) may be the result of an under-developed workflow, challenges with your process management, or training issues.
Not following up on submitted claims
Most practices work old claims from denials and aging reports. Though this seems like a reasonable approach, we have found that this approach often results in a small number of claims falling through the cracks each month. If the practice never receives a denial and the claim makes it to the 120+ bucket, the list is often so large that billers often do not make it through the list. With a large list of older claims, it also becomes difficult to determine which claims have been worked and which still need follow-up.
Patient Collection Problems
A reason for decreased cash flow may simply be patients not paying what they owe. Without a process to collect payments at the time of the visit and regular communication from you regarding patient balances (through statements and patient calls) patients may forget to make a payment. Making the process simple and electronic is key to encouraging prompt payment of patient balances.
Charge Volume Decreasing
Cash flow decreases can often be linked to fewer patients coming into your practice or missed service opportunities. Providing good care means knowing when patients are due for services and making sure that they are aware of these dates. Taking advantage of patient engagement tools and provider point of care reminders is key to providing better care, which also helps in the practice’s financial health.
How Curas can help
Optimizing your eClinicalWorks system may be just what it takes to get your cash flowing again. That’s why Curas offers Billing Optimization as one of our eClinicalWorks services. Our Billing Optimization service helps you identify and address key issues so that your billing workflows can run as efficiently as possible. With Curas’s help setting up your billing processes, your in-house staff will have the support they need to best perform them. We’re experienced with solving in-house challenges, and want to share our experience with you.
Outsource to RCM360®
If you would rather outsource your billing than have it optimized in-house, Curas has established a partner company just for that purpose. RCM360® is comprised of a team of professionals who are experienced with eClinicalWorks who can manage your billing and revenue cycle management. RCM360®’s goal is to offer simple, transparent, and comprehensive support for your billing needs. After analyzing and optimizing your eClinicalWorks Billing, RCM360® sets up processes, dashboards, reports, and regular meetings so you don’t have to wonder what the state of your billing is. RCM360® addresses all of the issues that may be causing a decreased cash flow, and regularly communicates progress.
Let us help your Billing process today!
Whether it is optimizing your processes with Curas, or letting RCM360® take care of the work for you, we want to ensure your practice’s cash flow runs smoothly and efficiently. Ask your Curas support team representative how Curas or RCM360® can support you today!