Key To Success: A Strong Revenue Cycle Management Firm

Our health care climate is deteriorating doctors' revenue. Period. Regardless of what you read, our reimbursement decreases every year even though our productivity remains the same. And I am in a specialty that has not experienced material reimbursement reductions from Medicare.

With all of the turmoil in the marketplace, one oasis a practice can find is a sound revenue cycle management firm - that’s medical billing for those over 50. While these companies are increasingly rare these days, a good one - a great one - can make the difference between public and private school for your kids.

Working in collaboration, a group and billing company can work together to identify areas for increased efficiency and greater profitability.

For example, my billing partner identified a marked decrease in drug reimbursement over a one to two month period. By analyzing this decline and using rather sophisticated analytics, our partner saved us considerable expense - - all the while navigating us away from the consequences of the eventual reimbursement pressure.

They have also helped identify private insurance companies who - unbeknownst to us - changed their compensation without warning. If we had continued to serve patients covered by this particular payor, I would have lost the opportunity to focus our growth of referrals from insurance companies with higher reimbursement. A good revenue cycle company helps to decrease revenue volatility, which in turn helps to maintain stable working capital - making you more money.

This essential relationship also helps guide our contracting strategy. When we had trouble collecting from patients due to high deductible insurance plans, we called in our billing team to identify any systemic issues. Unfortunately, we discoverd that the financial responsibility is increasingly on the patient rather than the insurance company.

When looking for the right billing partner one should understand the specialty-specific needs including optimal CPT and ICD9 codes. Along with your specialty specific coding, they should be trained for the October 1st switch to ICD-10. This is imperative if your practice wants to avoid volatility in the fall, and give your practice continued success.

Eric A. Wechsler, MD
Fellow of the National Kidney Foundation
CEO & Founder of the Pocket Dietitian