We've been facing subpar revenue for the past four months... I don't really know what to attribute it to either, as our patient number hasn't decrease as steadily as the gains. Not falling for a recession excuse either.
Does anybody have any thought or ideas, or have maybe experienced the same thing? One colleague told me about adding hearing services to our ophthalmic offerings. Seems like it would make sense but I'm sure the setup could be devastating as far fees, but I wonder if it will be good for the long run. The suggestion was
http://www.phsimd.com, has anyone taken these services into their practice?
Sub-par revenue or sub-par volume? Or both? You say it isn't a generation problem, so it seems you might have a collections problem. Adding more billable work when you don't address losses isn't the solution. All you will do is increase your losses.
First, have you looked at your accounts receivables? Are any of your payers stretching out or just not paying? If you have even a basic practice management program, you should be able to generate an account aging profile.
Have you compared what your payers are remitting with what they paid for the same code last year? Are they paying what their contract says they should pay you or are they shorting you? Are they denying claims for frivolous or unjustifiable reasons? If they are, is anyone working your claims denials with appeals?
Are you sending out bills to patients that aren't being paid? Are you billing regularly? Are you applying a rigorous process to delinquent accounts?
Are your superbills matching what is going out on your claims? Have you checked the accuracy --and fidelity, embezzlement and theft are real issues--of your front desk and collections processes.
Among my catalogue of practice skullduggery stories are a couple that come to mind: one employee at the front desk of a very busy practice where I worked once was deleting the posted codes for cash-pay refraction on the superbills once they left the hands of the doctor and then was pocketing the proceeds. Her scheme was uncovered when she was called up to national guard duty and an honest employee took her place. Cash collections at the front desk increased substantially.
Another larcenous employee was far less crafty. She just pilfered checks from the mail sent to the branch office she was hired to manage. That theft was caught when the payments from a carrier were missing and calls to the carrier revealed that the checks were sent and deposited, to the thief's account. Proving the theft suspicion was not difficult.
One came to light by accident. Because the front desk thief covered her tracks early, it was only her absence that changed the pattern that uncovered her acts (the superbills were opscan sheets and a search through the originals revealed that there was a consistent application of white-out on the ovals for refraction codes on her watch.) The other, by a little sleuthing.
So if your receipts are down, you need to keep all possibilities in mind. If you aren't being shorted by your payers, then someone may be stealing (or both.)
