Today, like many other specialties, sleep medicine is facing a decline in revenues as guidelines from insurance companies subtract the reimbursements you earn from treating patients. To complicate matters further, sleep medicine from 1st Providers Choice is experiencing a shift in the way care is provided due to a once-in-a-century pandemic.
So how do you protect yourself and your sleep medicine practice? Making sure the overall billing lifecycle is in tip-top shape and there are no avoidable issues.
5 Places to Focus Your Attention
All things being equal, apart from the contractual changes in the insurance sector, the decline in revenues is almost always attributable to operating systems and billing processes that need to be identified and improved. Think, for example, of prior authorizations! Only 13% of cases use a fully automated pre-authorization process which could reduce a lot of administrative time and errors in a manual system. But the practice has been slow to embrace the advanced technology available through cloud-based software, such as Infinx's prior authorization software solution.
We have identified five areas where attention can have a very positive impact on sleep medicine specialists.
1. Double Check Your Insurance Eligibility, Then Double Check!
Ensuring real-time, accurate and valid demographic and insurance information about the patient is critical to the entire reimbursement process. Each practice should begin by checking and double-checking eligibility so you can be sure patients have valid coverage. By leveraging a transparent insurance verification package and automation of benefit eligibility, your practice can instantly track and confirm the precise details of patient coverage, while avoiding subsequent denials of eligibility, including:
- patient eligibility and coverage dates,
- primary or secondary insurance relationship
- personal contribution and / or co-insurance due,
- paid annually and remaining deductible, e
- any own maximum.
Changes in fitness occur all the time and patients may not even understand the implications. By checking it at every meeting, by phone, for planning or telemedicine purposes, or in person, you can be sure that you are getting the most accurate information.
2. Be Sure to Record all Costs
It seems counterintuitive, but fees are often overlooked when providers are rushed, familiarized, or when providers choose not to check in within 24 hours of meeting the patient. A procedure, test, device or medication is missed or omitted, and it costs money. Missed charges add up quickly and waste your time, but often consumables, medications, etc. are podiatry practice management software costs.
Communicate with your sleep medicine practice team at 1st Providers Choice – they will often tell you directly where the gaps are and you can spot things that are overlooked in your practice or better yet, perform a systems audit that takes the super bill from inception to claims management and follow-up debt collection.
3. Collect all Parts of The Patient to Be Paid in Advance
Patients are taking on an increasing share of financial responsibility for their care, and sleep drug providers need to be proactive in educating them about their growing financial role. It has never been more important to establish the expectation that patient portions must be paid for before the service is provided. One effective way to improve the process is with real-time estimates provided before any scheduled care that 90% of patients will gladly pay for, especially when online payment options are provided.
4. Check The Encryption and Billing Function Regularly
Whether done internally or by an external ehr software partner, it regularly checks the coding and billing process from start to finish to ensure accuracy. This means that once the patient meeting is complete, the superbank is followed by the encryption function, the complaint submission process, and finally the outbound and direct debits (if needed).
It is important to have a trusting relationship with employees and external partners, but it is also important to verify that the work is done satisfactorily. This gives you peace of mind and ensures that your team is well trained and functioning.
5. Make Sure You Check The Company's Financial Indicators
There are several key metrics that will give you an overview of how your practice is progressing. Keep an eye on these numbers:
- Daily net production (Fees - Payments - Adjustments + Refunds)
- Monthly production by supplier
- Excellent rear ventilation
- 90-day AR less than 25%
- Number of applications rejected and reason for it
- Rates for missed appointments and no-shows
- over time
It is important that sleep medicine practices verify that business functions are working properly and that auditing systems are in place to ensure that workflow is performed according to your policies and procedures. As in any business, changes happen and systems can be interpreted differently or modified without your knowledge. By being proactive, you can be sure your office is performing as expected.
Contact 1st Providers Choice today to learn more about our sleep medicine practice and benefits, and our patient payment estimation solutions for your sleep medicine practice.