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Tips for maximizing reimbursement at your practice.
While your No. 1 priority on a daily basis is providing the highest quality patient care possible, your financial bottom line must also be a paramount concern. Without a healthy revenue stream, you’ll be less likely to meet the needs of both your patients and staff.
At this year’s annual meeting of AHRA: The Association of Medical Imaging Management, Melody Mulaik, president of Revenue Cycle Coding Strategies, discussed strategies for ensuring you capture as much revenue as you possibly can.
“Monetary concerns are what justifies everything. Organizations need to make sure that all possible revenue has been collected to ensure they have enough for staff, to purchase equipment, and to take care of everything else in the department,” Mulaik says. “Historically, imaging has been a revenue generator, and we want to continue to be a revenue generator.”
There are three main avenues you should concentrate on to ensure you are gathering as much of the revenue owed to you as you can, she says.
First, be sure each of your patients has received the proper pre-authorization or pre-certification before you schedule the appointment. If not, you are at risk for having to cancel appointments, forgoing the payment for services you could have rendered.
Second, she says, be sure to schedule your patients appropriately. If you don’t schedule enough patients during the day for imaging or you do schedule a patient without pre-authorization and have to cancel, you could be passing up money.
Related article: The State of Radiology Reimbursement in 2019
“Scheduling can have a large impact on equipment utilization,” Mulaik says. “Make sure you have a good scheduling process in place. Otherwise, you’ll have machines sitting idle.”
Leaving machines empty and technologists without patients to image can be a particular problem if you are part of a free standing or remote outpatient clinic. There’s not always another patient waiting who can jump in and fill that slot. Hospital departments are better positioned to fill empty spots with emergency department patients or other inpatients who need imaging.
Third, make sure you have the most up-to-date coding and reimbursement information included into your RIS or chargemaster, she says. If you are operating on outdated information, you are more likely to leave money on the table when you file for reimbursement. Or, she says, you could risk having your claims returned, slowing down how quickly you are paid for the services you provide.
Ultimately, she says, it is important for everyone in your practice to work collaboratively, understand your revenue processes, and feel free to speak up when they see behaviors that might be negatively impacting your financial stability.
“I think the problems practices typically face are process problems,” she says. “Employees don’t come to work wanting to make bad decisions. They’re following a process, but these tactics are places where people can make a big impact on their organization.”