There are many reasons why people who work in the healthcare industry are overwhelmed today. With all of the changes that have happened in recent years, such as the ICD-9 to ICD-10 transition, rising costs, the Affordable Care Act and increased paperwork, many practices and clinics are struggling just to keep their heads above water. With so much to juggle and keep track of these days, it can become easy to drop the ball and miss something important. Unfortunately, neglecting some duties can cut into your income and profits, which can ultimately hurt your practice in the long run.
Studies show that the typical practice wastes a considerably amount of potential net income due to collections issues or inefficiencies. However, there are a number of other factors that can contribute to financial issues for ENT practices and clinics.
Working with a professional healthcare consultant to provide you and your staff with updated information on education and training, medical billing services, authorization training and medical insurance verification is a big step in the right direction. Professional support services can also provide phone or online coding help to ensure that you don’t get any claims rejected based upon coding errors. The rest of this article will be dedicated to identifying the top seven reasons why ENT practices lose money so you can examine your office and see what needs to be done.
#1 – Productivity Issues
One of the most common ways that ENT practices lose money is by not seeing enough patients each day or by performing fewer services per visit for each patient. A recent healthcare study revealed that for every fee-for-service patient visit that is missed in a day, approximately $15,000 is lost throughout the course of the year. The other way that productivity can be a problem is in scheduling too many appointments for one day, which can minimize the number of services provided to each patient on each visit, resulting in a loss of reimbursement per hour for the time that is spent.
#2 – Coding Issues
Another way that many ENT practices lose money is through bad coding or coding errors. The ICD-9 to ICD-10 transition was overwhelming for many offices that did not properly prepare or test their skills and knowledge in advance of the change in October 2015. It is important to keep your knowledge of medical billing services and coding up to date to ensure timely reimbursement and avoid getting denied claims. Getting your staff the online coding help and support, as well as current education and training, can help you to overcoming coding issues or overly conservative coding that can end up costing you a lot of money in the long run.
#3 – Billing Practice Issues
It is important to stay familiar with the best practices for medical billing, including medical insurance verification and keeping up with authorization training. Bad billing practices can end up costing your practice a lot of money throughout the course of the year. Making sure your staff knows to update patient insurance coverage and verify insurance at every visit to make sure that claims are sent on time and to the correct location.
#4 – Fee Schedule Issues
One of the most important things that you can do to keep your practice operating as it should is to frequently and properly update your fee schedules. You need an up-to-date fee schedule to be able to properly calculate a fee-for-service equivalent for Medicare reimbursement. You should update your fees on a yearly basis through the help of a qualified consultant. Under-billing for just one or two services can cost you thousands of dollars each year.
#5 – Overtime & Staffing Issues
Practices and clinics need to stay on top of staffing issues, which could result in excessive and costly overtime. Overtime can cost even a small ENT practice thousands of dollars each year. While overtime can be necessary in many instances, it should still be controlled and monitored. If time management is an issue and work could have been completed during the schedule employee hours, this is something that needs to be addressed. In some cases, overtime can be unnecessary and can be reduced according to the situation. If overtime is frequent, additional staff may be required to help minimize overtime. If overtime is out of control, institute a rule that all overtime must be pre-approved or signed off on a case by case basis.
#6 – Budgetary Issues
Many practices do not have a budget. This comes from physicians not running their practices like a business. You should have a budget for staffing, supplies and all other overhead that is required to run your practice or clinic. Budgets should also be made with regard to services performed and anticipations on revenue coming from patient visits. If you do not have a budget, make sure to work with a qualified consultant to develop a budget for your practice right away.
#7 – Supply Purchasing Issues
Ordering supplies can be a real problem if you don’t get it under control. Ordering too many supplies can stress out your budget, but not ordering enough supplies can be a problem as well. An emergency supply replenishment can cost more than ordering ahead of time in bulk. Work with your office manager to make sure that supply purchasing is under control and stays within the monthly and annual budgets. Consider sending staff to education and training programs as needed for better supply purchasing management.
How MD Pro Solutions Can Help
Contact the team of professionals at MD Pro Solutions for help with your ENT practice or clinic. We can provide all of the education and training you require to improve your medical billing services to help make your practice more profitable. From online coding help and support to authorization training and updated skills for medical insurance verification, ICD-10 coding and more, you can trust MD Pro Solutions to provide the training and support that your staff needs. Give us a call at 508-946-1665 to get a FREE estimate on any of our services or to schedule an appointment for an evaluation.