Automating the Revenue Cycle

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A Web-based RCM system helps an Arkansas practice say goodbye to stale printed reports.

Revenue cycle challenges are growing for group practices. As patients become responsible for more of their bills while payers proliferate, alter their payment requirements and change regulations on what needs precertification, it becomes increasingly difficult for smaller or medium-size practices to keep up.

With 96 employees at the Arkansas Otolaryngology Center in Little Rock, Jan Hundley decided the practice couldn't afford enough manpower to do revenue cycle work on its own anymore. As chief operating officer of the 16-physician, five-location practice, Hundley says she'd had enough of having her employees manually filing claims, sending out patient statements, collecting money, posting it to the patient's account, and making phone call reminders and sending out mailed reminders to patients and insurers to get them to pay up.

Now, the front office enters the charge and makes sure it's coded correctly, then a vendor, Irving, TX-based MedSynergies, handles the rest. The Web-based revenue cycle management system allows Hundley and her team to benefit from automation and reassign workers in the practice. Hundley and one manager handle the data from the electronic reports she gets from the vendor and use that data to relay information to the clinicians about the state of the business and where problems are cropping up instead of waiting for a stale month-end printed report.

"We can access some fabulous reports at any moment of any day, and that's very different from just getting a month-end paper report," she says, adding that she can see cash collected, what charges have gone in and what payments have been received. "I can drill down to specialty audiology, hearing aid sales--whatever you want you can get."

She says the transformation has been stunning. "Now I can quickly identify problems, such as the lack of receipt of payment from an insurance company." When times were simpler, she says, patients could present a Blue Cross card and the practice administration knew they would eventually be paid.

"Now, for Blue Cross, there may be 30 different plans with deductibles all over the map," she says. "That can cause headaches, and with a lot of patients switching to high deductibles and HSAs, you have to have an automated solution like this."

-Philip Betbeze