Medical practices everywhere need to take a good hard look at their medical revenue cycle. The implementation of ICD-10 is around the corner and it’s expected to have a major impact on how revenue cycles are managed. Accounts receivable delays, rejections, and denial rates are all expected to peak. Payment variations that were once small sums of money will rise, and accumulate quickly.
(Are you taking ICD-10 seriously? Here’s why you should ignore the grace period.)

Assess your medical revenue cycle now and prepare for the future. Make sure your practice has a strong hold on underpayments and contract compliance policies.

Underpayments

Practices need to stay alert when it comes to underpayments. Underpayments are to be expected, but it’s important to consistently oversee them and seek the necessary reimbursements.

Most medical practices have systems in place to help with underpayments via contract compliance, but nothing really deals with underpayments with overwhelming success. By staying top of even the smallest payment variations from payers, practices can prevent a potentially large sum of money from accumulating and going missing from a medical revenue cycle.

Contracts

In order to avoid lost funds down the line, practices need to ensure they are staying up to date on their fee schedules and contract compliance policies. If your fee schedules go out of date, underpayments will go unpaid. It’s important to make sure both parties (payer and practice) have a mutual and thorough understanding of their contracts. Many times these contracts are built on time-sensitive reimbursement for improper payments.

Failure to understand a time restraint issue could prevent your revenue management team from filing for reimbursement within time limits, and lose money. This is especially crucial to oversee during the ICD-10 switch, as incorrect coding will need to be found as soon as possible in order to receive proper payments. A limit in reimbursement time limits the time to correct coding errors.

The best way to be confident your medical revenue cycle will go unharmed is to start by paying close attention to issues that may already be occurring, gaining as much knowledge you can of ICD-10, and develop a plan of action.

Are you worried about the effect of ICD-10 on your medical revenue cycle? MEREM Health’s professional coders can help ensure you stay coding correctly. Contact us today for help with managing your revenue cycle effectively and professionally.