Top 3 Practice Management Strategies for Ongoing Success

Optimize front-end processes

Getting information right the first time can ease many back-office headaches and ensure timely reimbursement—something practices need during this difficult economic time. Optimizing front-end processes like patient registration and insurance eligibility verification is key to creating a smooth experience for both patients and providers.

A practice leveraging this strategy with success is Missouri-based South County Urological.

“We're always trying to be more efficient. One of the ways was to try to streamline a very antiquated process,” said Theresa Hammack, officer manager at South County Urological, referring to the practice’s front-end procedures.

“Being a specialist office, there are referrals many of the times. We also have a lot of managed care plans in our area here,” Hammack added. “Many times, patients were sitting at the front desk because a referral was supposed to come and it never did. There wasn’t good follow-up to verify that it was received before the patient arrived.”

The practice leverages its practice management system to automate patient financial clearance before the patient even came through the doors for an appointment. The strategy prevented long wait times while patients completed information at the front desk and increased point-of-service collections by about 300 percent. Coordination of benefit denials also declined by 75 percent, Hammack reported.

Preparation prior to the patient encounter can make the entire experience, from registration to reimbursement, much smoother if practices can streamline front-end processes. Practices can also look to their practice management systems to start this transformation.

Automate when possible

Patient financial clearance isn’t the only process that can benefit from automation. Technology is a key resource for physician practices, especially when human resources are low in their communities.

Unfortunately, practices do not always have the most sophisticated technology for optimal practice management. Practices generally have practice management systems, but many organizations still need to turn on capabilities or tap other solutions to complement workflows.

Financial analytics within a practice management system, for example, can help practice leaders glean insights in near real-time to improve processes before issues with claim denials, reimbursement delays, and the like emerge.

Introducing new solutions is a journey, not a destination though, Gene Austin, CEO of Columbia Orthopaedic Group, recently told RevCycleIntelligence.

The specialty practice located in Missouri had a practice management system in place but decided that it needed more information from its technology to understand trends. Austin decided to implement a new system paired with practice analytics. The team also focused its automation efforts on accounts receivable (A/R) management.

“It also provides excellent metrics for us to determine the effectiveness of a team member, what their work has done, what they've accomplished and so forth, so it's a great benchmarking tool, as well,” Austin stated.

With improvements realized on the A/R management front, the practice has moved its focus to patient balance follow-up. But overall, Austin said the automation journey has the patient in mind to make the experience more convenient.

Outsourcing is an option

With any small business, resources and capital may not be readily available. This may be especially true for physician practices, which recently experienced a dramatic reduction in patient volumes and revenues because of the COVID-19 pandemic. Additionally, qualified healthcare professionals can oftentimes be hard to find even without a global pandemic.

Outsourcing practice management and revenue cycle management functions is an option for practices finding themselves without the staff or resources to execute successful practice management strategies.

For example, Tucson Gastroenterology in Arizona has turned to outsourcing some functions after the practice experienced a rush of turnover. During that period, the practice lost some key billers that had been with the practice for decades, explained Julie Wester, contract administrator.

The practice decided to partner with an outsourcing vendor to process claims and other revenue cycle management tasks. The key word here being “partner,” Wester emphasized.

“We had a conversation about what kind of partnership we could build,” Wester explained. Through the partnership, the practice felt it was leveraging experts in the revenue cycle management space while taking some responsibilities off the plate of a smaller team. Outsourcing the functions enabled that team to focus more on getting information more accurately and making the overall experience smoother. And revenue cycle outsourcing is helping Tucson Gastroenterology bridge those extra percentage points by “improving internal operational efficiencies while increasing the transparency into the financial health of the practice,” which has always been a priority but was difficult to execute, Wester explained.

For outsourcing to be successful though, Wester stressed that practices need a true partner who is willing to be transparent about trends and who can specialize in the practice’s exact needs. For example, Tucson Gastroenterology’s partner understands the nuances of billing for gastroenterology services.

“Everything in healthcare is very specialty-driven,” Wester explained. “So we’re pushing through the claims and if you’re not really attuned to your specialty, its coding, and how things are processed, it can fly under the radar.”

Whether practices partner with an outsourcing company, tap into technology, or optimize their front-end processes, these practice management strategies can help leaders ensure ongoing success. The strategies are designed to free up staff to focus on more value-adding activities. These activities can improve the patient experience, streamline operations, and capture more revenue.