As I wrote last week, Kareo was proud to sponsor a session on September 22, 2010, at Physicians Practice Live on “Billing: Top 5 Challenges of Today and Tomorrow” presented by practice management expert Judy Capko.
More than 340 people attended this virtual session, which offered an excellent overview of the challenges faced by physicians, medical billers and all those who rely on medical billing for their livelihood. Ms. Capko is writing an article based on the session for an upcoming issue of our newsletter, Getting Paid, but in the meantime here is an overview of her session.
CHALLENGE 1: Patients Pay a Larger Share
In order to address this challenge, Ms. Capko says a change in procedures may be required, and when implementing a change, it’s important to educate and inform patients, confirm appointments to reduce no-show rates and collect co-pays consistently. She also recommends setting collection goals, training staff appropriately and holding all staff accountable.
CHALLENGE 2: Insufficient Payer Reimbursement
The key in this area, according to Ms. Capko, is to analyze payer performance and identify poor performing payers. Then it’s important to respond to the analysis by strengthening payer relationships, develop a negotiation strategy, drop poor performing payers when necessary and grow the practice with better payers.
CHALLENGE 3: Labor Intensive Processes
Medical billing is a labor-intensive process, which no doubt comes as no surprise to you. Contributing to this challenge are inconsistent processes and outcomes. Keys to alleviating this challenge include lean management, increased automation and appropriate tracking and accountability.
CHALLENGE 4: Retaining Top-Notch Staff
Hiring and retaining top-notch staff is a big challenge for any business, and especially in the area of medical billing. Ms. Capko feels practices need to demand a greater level of expertise to achieve the success desired. Of course, even in this economy practices are competing for the best employees, so it’s important to ask questions including:
• How attractive is your practice opportunity?
• What significant changes can be made to appeal to the
• best candidates?
• Does your culture truly value staff?
• Does your practice invest in tools and training?
• What opportunities for growth do you offer?
CHALLENGE 5: Staying Ahead of the Curve
One of the biggest challenges in healthcare at present is the large and varied changes presented in the form of new legislation and government initiatives. These include healthcare reform, EHR and meaningful use, PQRI and others. Ms. Capko advises that staying informed is key to dealing with the changing playing field, as well as recognizing that these issues are not going away.
Ms. Capko also addressed the challenges of the future, including:
• Medical Necessity
• Medical Home
• RTCA (Real Time Claims Adjudication)
As I mentioned above, Ms. Capko will discuss these topics in greater depth in an upcoming article in our newsletter. In the meantime, if you would like to hear her presentation, you can do that free at the archived version of Physicians Practice Live. The archive will be available until March 22, 2011.