Tom’s Top Ten (Weaknesses in the Physician Revenue Cycle) Tom Ealey, an experienced practice administrator and practice management consultant, is an associate professor of business administration at ALMA College in Alma Michigan.
Disclaimer: Any opinions expressed are those of the seminar leader and not those of the Health Care Compliance Association or Alma College. This seminar is not an attempt to provide legal or consulting advice. Such advice should always be obtained from professionals with the proper licensing and qualifications.
Weaknesses in the Physician Revenue Cycle
At least we agree on the date for the Christmas party!
Weaknesses in the Physician Revenue Cycle
#1 Weak governance in the physician group creates many problems, and is likely to leave the group unable to develop and implement an effective compliance plan.
Weaknesses in the Physician Revenue Cycle
The rules do not apply to Me, the rules apply to staff. I am a physician, after all.
Weaknesses in the Physician Revenue Cycle
#2 Some physicians do not believe the rules apply to them. Several are likely mopping the dining hall in a federal prison this very moment.
Weaknesses in the Physician Revenue Cycle
Which Bob Smith? We have ten of them!
Weaknesses in the Physician Revenue Cycle
#3 Weaknesses in gathering and maintaining demographics and insurance information plague physician office revenue cycles.
Weaknesses in the Physician Revenue Cycle
We are too busy to get organized!
Weaknesses in the Physician Revenue Cycle
#4 The Busyness Syndrome The pace in a physician practice is fast and relentless. Being behind becomes par for the course. Niceties such as organizing and training get left behind.
Weaknesses in the Physician Revenue Cycle
What management should be: plan > organize > direct > control> feedback> plan………. What management becomes: hang on for dear life!
Weaknesses in the Physician Revenue Cycle
There are about 7800 CPT codes, how am I supposed to understand all this??!!
Weaknesses in the Physician Revenue Cycle
#5
Accurate coding requires constant training, monitoring, auditing, and feedback.
Weaknesses in the Physician Revenue Cycle
Stark, doesn’t he play cornerback for the Steelers?
Weaknesses in the Physician Revenue Cycle
#6 Keeping up with the regulations requires a constant effort and lots of reading, plus regular training efforts for physicians and staff.
Weaknesses in the Physician Revenue Cycle
We are collecting a lot of money so everything must be ok, right?
Weaknesses in the Physician Revenue Cycle
#7 Missing the details – denial follow up, hold accounts, write offs, co-pays, bad checks, payer correspondence, etc.
Weaknesses in the Physician Revenue Cycle
We have a compliance plan, I have a copy of it here somewhere, ah, I know I can find it, ah, maybe this drawer.
Weaknesses in the Physician Revenue Cycle
#8 No compliance plan, a cook book plan or a plan that no one pays much attention to.
Weaknesses in the Physician Revenue Cycle
I like young doctors, they have all sorts of interesting coding ideas!
Weaknesses in the Physician Revenue Cycle
#9 Failure to watch trouble spots; new doctors, impaired doctors, doctors who are obsessed with the bonus plan, etc.
Weaknesses in the Physician Revenue Cycle
The vendor said this thing would work miracles for us. It’s got a lot of gigabytes and RAM and stuff.
Weaknesses in the Physician Revenue Cycle
#10 Bought the wrong system, or did a poor job of installation and/or training, or failed to use all of the components, or otherwise failed to control the practice management software.
Weaknesses in the Physician Revenue Cycle
So what is the cure for the physician revenue cycle? •Relentless attention to detail •Constant monitoring and auditing - data •Follow the flow – front desk to bank deposit •Constant Quality Improvement (CQI)
Weaknesses in the Physician Revenue Cycle
Contact Tom at: ealey@alma.edu or (989) 463-7135 Also read his work at: http://practicemanagementnews.blogspot.com/ http://healthcarethinktank.blogspot.com/
Weaknesses in the Physician Revenue Cycle
THANK YOU!