Revenue management is one of the top concerns of small medical practices. Disruptions, even small ones, can have a huge impact on your financial health. When you rely on a billing services provider to manage your revenue, you display a tremendous trust in them, but tolerating poor performance from your billing service provider can get you into serious financial trouble.
How do you know if it’s time to change billing service providers? Here are five red flags to watch for:
1. An increasing claims rejection rate. As a billing service provider begins to work with your practice claims, rejections should decrease and stabilize. If your existing provider is reporting month-to-month increases in rejections, there might be a serious issue related to their processes or staff. If you are no longer familiar or comfortable with the resources your provider supplies, it may be time to shop for a new service.
2. Billing reports that are unclear and complicated. Your practice should receive monthly reports that are easy to understand, clear and concise. If your billing service providers are not providing clean and accurate reports, and supplying recommendations to improve your financial performance, it may be time to evaluate another billing firm.
3. Increases in disputes, inquiries, and late collections from previously prompt payers. If existing payer relationships begin to sour, you’ll see an increase in disputes, requests for supporting material, and slower payment. These may not be issues with the payer but may indicate that there is a problem with your billing services provider.
4. Decreased patient collections. When patients express surprise at the amount of their bill, or have a dispute over the amount that is due, they typically have one reaction: They don’t pay their bill. A decrease in patient collections may indicate an imbalance in the amount paid by the insurance company and the amount owed by the patient. A credible billing service knows that getting the claims accurately and correctly submitted and paid by the insurance company is a primary driver of patient collections. If your patient collections are decreasing, it may be time to review claims submission as the root issue.
5. Resistance to the use of automation and technology. Modern and effective billing services providers are implementing automated systems and using technology to gain maximum performance and speed. Electronic submissions, integrated clearinghouse, and on-line reporting to see up-to-the-moment status of revenue cycles are billing service provider best practices. If your provider is resisting the use of technology and has no plans for innovating, it may be time for an upgrade.
The existence of any one of these red flags may be having a substantial impact on your practice. If you recognize more than one of these red flags, your practice may be struggling with its financial management. The longer the issues continue, the harder it will be to recover the revenue your practice deserves.
ZH Healthcare provides comprehensive billing services that improve cash flow, increase revenue, and help you manage the financial health of your practice. To find out more about ZH Healthcare and how their OpenEMR and Billing Service Solutions can help your practice visit zhhealthcare.com/billing