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How to Select a Medical Practice Management System

Prior to implementing a practice management system that automated its billing operations, the staff at Tri-County Eye Physicians and Surgeons in Southampton, Pa., often waited weeks before learning that a claim had been denied due to mismatched diagnosis and procedure codes. Since going electronic, the practice has not only eliminated that wait but prevented errors from occurring in the first place.

Although costly, practice management systems are becoming essential for efficiency, experts say. Physicians can cut costs and boost revenue by automating everyday tasks like claim submissions and insurance authorizations. Read more about how to select the best system and take advantage of new features in this article I wrote for Physicians Practice.

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Revenue Cycle Management: Preventing Claim Denials

Preventing denials requires careful documentation but physicians don’t always make the connection between poor documentation and declining revenue. As a result, some offices get stuck in a downward spiral that’s difficult to reverse without a coordinated effort between the front and back office.

Revenue cycle management experts I spoke with had some great tips for reversing that negative trend. Here are 5 worth noting:

Communicate. Physicians, nurse practitioners, and physician assistants should receive frequent, direct feedback about the quality of their documentation. Whether your billing staff is medical revenue cycleon-site or you work with a third-party, you need to know how often and why your claims are denied. Consider having regular staff meetings or online discussions focused on billing and coding.

Test for coding competency. Perform a baseline assessment of providers’ coding skills and repeat it twice a year to make sure everyone is up to speed.

Invest in training. Both newly hired and established providers should undergo regular training and refresher courses on coding and documentation. Remember: poor documentation + inaccurate coding = denied claim (and lost revenue).

Show them the money. Complying with coding audits and attending educational seminars should be tied to financial compensation and/or bonuses.

Use technology. “Scrubber” tools embedded in your practice management system search for coding errors and generate reports on recurrent problems–consult them regularly to avoid repeating common errors.

 

Please see the longer version of this column that I wrote for Physicians Practice.

 

 

 

 

 

 

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