Making the Most of Your revenue cycle management technology

1. Making the Most of Your revenue cycle management technology Shelly guffey 11.15.12

2. Objectives Identify key questions Prepare your staff to fully leverage technology Create written policies

3. State of the health care industry Declining Medicare reimbursements Growing patient responsibility for payments Industry transitions will impact revenue flow Source: American Health Information Management Association

4. Managing your revenue cycle Many medical practices report a gross collection rate of 60% or less • For every $1.00 billed, physicians are only reimbursed $0.60 Source: MGMA’s Physician Billing Process: 12 Potholes to Avoid in the Road to Getting Paid, 2nd ed.

5. revenue cycle management technology Impact of using technology Practices who use revenue cycle management technology consistently outperform their peers • Cost • Revenue Source: LarsonAllen study, 2010

6. revenue cycle management technology Impact of rcm technology Technology adopters collected more than 50% of outstanding receivables in 15 days or less • Providers who did not use technology efficiently collected only 9% Source: LarsonAllen study, 2010

7. Revenue Cycle Management Technology How can you make the most of your revenue cycle management technology?

8. Making the most of your technology Integrate technology seamlessly Minimize disruptions to staff during integration Break integration into phases Consider how tools will fit within other systems Fit within your existing workflow

9. Making the most of your technology Ensure vendor offers support How will they provide support? How often are their tools updated to keep current? How will the tool work within your existing systems? How will they train your staff? Do they offer user group meetings or webcasts? Can you call client references? Questions to ask Vendors about their support

10. Making the most of your technology Test technology tools WITH STAFF Involve several staff members in testing Take staff feedback into consideration when selecting a tool Test options

11. Making the most of your technology Prepare your staff to use tools Determine who needs to interact with new system Hold training sessions Inform clinical staff how their work may impact the practice’s revenue cycle Involve staff in continued education and professional organizations Train staff to use new technology

12. Making the most of your technology Create policies for technology use Create standards for billing processes Record policies in writing Establish policies to improve efficiency

13. Making the most of your technology Utilize reporting features Track how quickly claims are submitted Analyze frequent errors and denials Monitor days in A/R Benchmark to improve performance Utilize reports

14. Making the most of your technology Correct claims rejections On average, it costs practices $40 in staff time to rework a denied claim Correct claims rejections within 48 hours of submitting the claim Develop a process to identify and address common rejections Correct claims rejections

15. Making the most of your technology Identify frequent rejections Identify the top rejection for your practice Educate your staff on correct coding for that rejection Continue to eliminate common rejections that have the most impact on your practice Identify frequent rejections

16. Making the most of your technology CHECK patient eligibility Only 79% of practices check patient eligibility Only 24% of practices check patient eligibility at every visit Use eligibility tools to quickly verify patient eligibility prior to the appointment Check Patient eligibility

17. Making the most of your technology Educate patients about payments Talk with patients in advance about expected payment owed Collect patient payment at time of service Offer financing options Educate your patients about payments owed

18. Making the most of your technology Collect Patient Payments Patient eligibility checks and other tools can help you calculate patient payment Enable multiple payment options (cash, checks, credit cards) to collect at time of service Create installment plan payment options Collect patient payments

19. Making the most of your technology Offer electronic payment options Enable off-hours patient payments Create online payment portal for easy access Offer electronic payment options

20. Making the most of your technology Select technology that can grow Choose products that allow for expansion and upgrades For example, Epic and Gateway EDI are always adding features and upgrades to keep up with industry changes Select technology that grows with you

21. To Manage your revenue cycle, ALWAYS: Identify one staff member to review insurance payments for accuracy Review EOBs and ERAs to address delays, denials and reductions Analyze reason and remark codes on payment adjustments Verify patient insurance eligibility prior to each visit

22. TO manage your revenue cycle, Always: Keep copies of fee schedules and health insurer contracts Create a plan to upgrade electronic transactions for ICD-10 Meet with your claims processing team regularly to evaluate workflow for ways to improve efficiency

23. To Manage your revenue cycle, Daily: Submit claims and statements Receive remittance advice files and reports Balance claims files against totals from your Practice Management System Manage primary and secondary rejections Post remits in your Practice Management System

24. To Manage your revenue cycle, Weekly: Verify that rejected claims have been corrected and resubmitted Analyze claims rejections to spot and correct common errors Ensure all claims have reached appropriate payers

25. To Manage your revenue cycle, MONTHLY: Balance claims statistics to create a snapshot of your office’s performance Compare your office’s performance to industry benchmarks Share news on industry trends and changes with your staff

26. Key Takeaways Practices who use revenue cycle management technology see positive results Training staff to utilize technology helps you collect more revenue and reduce staff time Establishing clear policies for posting claims and collecting patient payments helps manage your revenue cycle more efficiently

27. Q + A

28. Shelly guffey 800.969.3666 ext1450 sguffey@GatewayEDI.com

29. The Bedside manner your revenue deserves™ Thank you. 11.15.12