Eva-Marie Alexander, west coast regional director of AAPC Physician Services, discusses five ways for orthopedic practices to maintain profitability and growth in their community.
1. Know what is going on in the market. Stay abreast of social and economic changes within your community. If you see a dip in patient scheduling, figure out on the cause. The dip could be related to a large-scale lay-off in the community or other factors discouraging patients from seeking elective orthopedic treatment or surgery. Knowing the reasons why patient flow to your practice is down can help you find solutions to the problem, says Ms. Alexander.
2. Ask why patients need to cancel visits. If patients are calling and cancelling visits, figure out why. It may be that they have high deductible individual plans or that you don't take their insurance plan. If a large number of the patients seeking your services are insured by a company you don't contract with, you might want to consider contacting that company to form a contract in the future.
In some cases, the patient may want to pay cash for the visit and could cancel because of high rates. "Smart physicians have come up with a discount for cash-paying patients as well as with other ancillary services (radiology, lab, etc.) they might need to refer their patients to," says Ms. Alexander.
3. Keep track of claim coding. Make sure your staff is coding correctly. "Under-coding is a big problem because it can mean a financial loss," says Ms. Alexander. "Prepare your staff for ICD-10. There are a lot of changes and the staff needs to be prepared." This includes physicians who need to provide complete and much more detailed documentation to allow the coder to code for the appropriate diagnosis. Also make sure the physicians are providing complete documentation for their services. Coders must have a clear picture of the services rendered, the medical history of the patient, as well and treatments provided to accurately code the claim.
4. Conduct coding audits. Look at fluctuation in payor mix during these audits and identify any changes in collections. If one physician-partner is making more money for the same kind of services or procedures performed as others, consider auditing and comparing the physician documentation to get to the root of it. See what type of patients the more profitable surgeons see and how you might be able to capitalize on this success. "Whenever you see a change or a trend, figure out why it is happening and what you can do to fix or expand upon it," says Ms. Alexander.
5. Tighten upfront collection. Standardize the system for upfront collections from patients so your entire staff knows their responsibility. Write the financial policy in a professional way to make sure the patient pays upfront. "Train the staff to really make the process flawless, and make sure everyone disseminates the same information to patients," says Ms. Alexander. "Have one set of financial policies and stick to that."
Learn more about AAPC Physician Services.
Read other coverage on orthopedic and spine practice profits:
- 4 Inexpensive Ways to Boost Orthopedic Practice Profitability
- 5 Ways to Make a Good Orthopedic Practice Great
- 6 Best Practices for Effectively Managing Large Orthopedic Practices
1. Know what is going on in the market. Stay abreast of social and economic changes within your community. If you see a dip in patient scheduling, figure out on the cause. The dip could be related to a large-scale lay-off in the community or other factors discouraging patients from seeking elective orthopedic treatment or surgery. Knowing the reasons why patient flow to your practice is down can help you find solutions to the problem, says Ms. Alexander.
2. Ask why patients need to cancel visits. If patients are calling and cancelling visits, figure out why. It may be that they have high deductible individual plans or that you don't take their insurance plan. If a large number of the patients seeking your services are insured by a company you don't contract with, you might want to consider contacting that company to form a contract in the future.
In some cases, the patient may want to pay cash for the visit and could cancel because of high rates. "Smart physicians have come up with a discount for cash-paying patients as well as with other ancillary services (radiology, lab, etc.) they might need to refer their patients to," says Ms. Alexander.
3. Keep track of claim coding. Make sure your staff is coding correctly. "Under-coding is a big problem because it can mean a financial loss," says Ms. Alexander. "Prepare your staff for ICD-10. There are a lot of changes and the staff needs to be prepared." This includes physicians who need to provide complete and much more detailed documentation to allow the coder to code for the appropriate diagnosis. Also make sure the physicians are providing complete documentation for their services. Coders must have a clear picture of the services rendered, the medical history of the patient, as well and treatments provided to accurately code the claim.
4. Conduct coding audits. Look at fluctuation in payor mix during these audits and identify any changes in collections. If one physician-partner is making more money for the same kind of services or procedures performed as others, consider auditing and comparing the physician documentation to get to the root of it. See what type of patients the more profitable surgeons see and how you might be able to capitalize on this success. "Whenever you see a change or a trend, figure out why it is happening and what you can do to fix or expand upon it," says Ms. Alexander.
5. Tighten upfront collection. Standardize the system for upfront collections from patients so your entire staff knows their responsibility. Write the financial policy in a professional way to make sure the patient pays upfront. "Train the staff to really make the process flawless, and make sure everyone disseminates the same information to patients," says Ms. Alexander. "Have one set of financial policies and stick to that."
Learn more about AAPC Physician Services.
Read other coverage on orthopedic and spine practice profits:
- 4 Inexpensive Ways to Boost Orthopedic Practice Profitability
- 5 Ways to Make a Good Orthopedic Practice Great
- 6 Best Practices for Effectively Managing Large Orthopedic Practices