The greatest imperative is to strengthen the practice’s financial competencies. Your goals should be to maintain and increase profitability; to collect full, prompt and accurate payments from insurers and patients; and to prepare your practice for risk-based payer contracts and other new reimbursement models. And, although the deadline is a year away, forward-looking practices are preparing for the transition to ICD-10 diagnosis coding.
Successful practices achieve these goals using several strategies. First, they’re enhancing their contract audit and recovery processes to maximize compliance with payer contract terms. They’ve developed a central financial infrastructure that’s optimized for current payment modalities yet adaptable to the new models on the horizon, such as bundled payments, value-based payments, pay-for-performance, ACOs and patient-centered medical homes.
These practices have worked aggressively to reduce the incidence of denied claims, the number of days of billings and claims still in accounts receivable, and the number of claims processing errors (at both the practice and payer ends). Many of them also are carrying out benchmarking against other practices to identify operational areas where performance can be improved.