Way back when I was a little kid and we only had three television channels (assuming the cloud cover and wind direction were co-operating), I would get up every morning at 8:00 AM to watch Captain Kangaroo on Channel 8. One of my favorite segments of the show was story time, when the Captain, famously played by Bob Keeshan would read a children’s book aloud. Remember Caps for Sale? My personal favorite was Stone Soup, a tale of soldiers tricking miserly villages into cooking them a feast. The children’s takeaway from the story is, of course, sharing, but it also illustrates the simple truth that making good soup is the result of combining all the right fixings.
Good revenue cycle management is a lot like making stone soup. As third-party payors move from traditional fee-for-service to pay-for-quality, getting best results from our revenue efforts is a more and more complicated business, and the recipe for success will include new and seldom or never before used ingredients.
Where once a working knowledge of reimbursement contracts and payor mix was sufficient for sound decision making, reimbursement trends and the emergence of new and experimental payment models require that physicians and practice managers be informed about a whole host of factors affecting the revenue cycle.
Any good cook knows that the quality of the ingredients is critical to success. Likewise, effective revenue cycle management requires everyone in the practice front and business offices do their job well. It’s almost silly to bring it up, but accurate patient registration information is better than inaccurate patient registration information. Timely filing is better than un-timely filing. Up-to-date credentialing is better than sloppy, inattentive credentialing. You get the idea.
Patient registration, ICD and CPT coding, data exchange, electronic claims, patient statements, follow-up, denial management, payment posting, bank deposits, prior authorizations, appointment scheduling, credentialing, compliance, PQRS, meaningful use, fee schedule analysis, payor contracting, reimbursement analysis, work flow, adequate staffing, and training all require constant attention to insure all best practices are followed. It’s enough to make your head spin.
Many practices find peace of mind in working with The Cvikota Company. As comprehensive revenue cycle management experts, we focus unrelentingly on every part of the revenue process. Add to that the most personal attention available in the industry, and you can see why so many physicians rely on us.