What could I gain from doing an audit? GOALS

The results from any audit are measured against industry benchmarks. If you are struggling to meet or keep up with these standards, a billing and coding audit should be performed in order to help you understand the key areas where your clinical operations are weak and help you to identify priorities and set goals toward making improvements that impact your revenue cycle.

At MEREM Healthcare Solutions, we call these standards, Industry Benchmarks, and it is our mission that all of our clients meet and exceed industry benchmarks.

What is a REVENUE CYCLE AUDIT?

A practice operation review tool used over a period of time to help you improve your current revenue process. We believe that routine, internal audits of your billing and coding processes are necessary. Every time an audit cycle is completed, there should be further improvement in patient care.

WHAT ARE INDICATORS THAT IT’S TIME FOR A REVENUE CYCLE AUDIT?

Is your practice losing money? – An audit will help you identify revenue loss and set goals focused on profit potential.

How quickly are your claims being followed up upon initial denial? – Efforts to reduce claim denials should begin with a revenue cycle audit to help you identify the source of denial trends.

Are you confident in your in-house/outsourced coding accuracy? – Coding services are the life-blood of your practice. That is how the services you provide are transformed into billable revenue.

A complete Revenue Cycle Audit includes:

• Coding accuracy audit
• Billing and accounts receivable audit
• Industry Benchmark Comparison for your individual practice

Conducting a revenue cycle audit in-house may take away from your daily responsibilities, and be a daunting task. Considering an outsourced solution for conducting your audit will help you stay on track and focused on continually improving your processes.

Whether you currently handle your billing and coding in-house or outsource to another company, MEREM Healthcare Solutions can provide you with an unbiased industry comparison and revenue cycle audit report to assist physicians and practice managers with improving their practice performance. Our audit results are always kept confidential for our client’s internal use only.

MEREM Healthcare Solutions is a Birmingham, AL-based company that has been providing exceptional medical billing and coding services to physician practices and ambulatory surgical centers since 2008.
We pride ourselves on not just maintaining, but exceeding, the level of accountability, communication, and customer service that is valued in traditional, on-site billing departments.
Please check out our other blog posts, or contact us to learn more.

The post Auditing With NO Fear, NO Frustration and NO Faults appeared first on MEREM Health.

What if your medical billing team went away tomorrow?

It’s happened to more than one practice.

Like many specialty medical practices, you probably have an in-house team that handles your revenue cycle management; From billing to coding, to auditing, collections, payment posting, claims re-submissions and dealing with payors. For some practices, this in-house arrangement works just fine, but have you ever thought about what would happen if your in-house team happened to fall apart, either because of employees finding other jobs or even retiring?

It’s every physician’s nightmare, but it doesn’t have to be. In fact, it might be time to explore another solution. A solution that would keep your revenue cycle management intact, no matter the circumstances of your practice.

Here are 2 significant advantages your practice would have if you considered outsourcing critical revenue cycle processes and leaving your team to focus on patient care and follow-up:

1. Many in-house medical billing and coding teams fail to keep up with changing regulations

Merem Healthcare Solutions Director of Billing Operations, Jennifer Smith, knows about this challenge intimately. She explains, “Carriers will change their policies and guidelines frequently. Without the proper knowledge and resources to stay up to date on these changes, this could be an extremely risky situation that could lead to lower reimbursement and an increase in denials.” Lower reimbursements and increases in denials obviously impact your practice’s bottom line in a big way.

When considering outsourced solutions, you will want to look for a strategic partner staffed with healthcare executives who have spent years in the physician practice space. These types of leaders have experienced these problems first-hand, and have developed proven solutions that have a mission of meeting or beating industry benchmarks, which are:

•  % of outstanding A/R = less than 120 days or -15% or less
• 30 days or less in A/R
• 97% or above net collection rate
• Coding accuracy above 98%

You should examine whether your existing office staff is currently meeting or exceeding these goals, and if they are not, you should consider outsourcing.

2. Many in-house medical billing and coding teams occasionally miss charges

Let’s face it, your in-house teams do a lot more than just billing and coding. In busy physician practices, they might also be asked to answer phones, do patient intake, and handle other tasks that interrupt their regular day-to-day jobs. It’s not their fault; it’s the nature of a busy, profitable physician practice. And when this multi-tasking is taking place, it stands to reason that employees are occasionally missing charges, among other things.

If this is the case at YOUR practice, you might consider an off-site outsourcing solution as a resolution to these issues that will invariably come up with an in-house staff. Jennifer Smith points out, “This is our team’s job every day, and they do it well. They have the resources available to locate and stop denial trends and/or carrier changes. They are not interrupted by other duties and responsibilities, as is what often happens within physician practices.”

As you probably already knew, there are several “gotcha” moments in the lifecycle of in-house revenue cycle management, which adds up over time in terms of revenue lost, inefficient productivity, and lack of ongoing training. Simplify your practice and your life by considering the advantages that outsourcing brings, and spend more time focusing on the things that are really important to you and your practice.

Merem Healthcare Solutions offers services for every step in a practice’s revenue cycle management. We can start from the beginning from credentialing and end with payment posting once an account has been satisfied. We offer a wide range of solutions which include auditing, billing, coding, consulting, credentialing, payment posting, practice management, and pre-collections training. Check us out on our website or feel free to call us to see how we can help run your practice like a well-oiled machine – (205) 329-7519.

MEREM Healthcare Solutions is a Birmingham, AL-based company that has been providing exceptional medical billing and coding services to physician practices and ambulatory surgical centers since 2008.
We pride ourselves on not just maintaining, but exceeding, the level of accountability, communication, and customer service that is valued in traditional, on-site billing departments.

Please check out our other blog posts, or contact us to learn more.

The post What if your billing team went away tomorrow? appeared first on MEREM Health.