Collection Rates Are Important — But Only Part of the Story
The most important job for any medical practice is obvious — deliver quality healthcare. Opinions will vary as to the second-most important job, but effective Revenue Cycle Management is near the top of anyone’s list. After all, any business that can’t collect payments efficiently may struggle.
On average, medical practices do manage to collect most of the revenue due to them. According to Medical Service Billing Review, the average medical billing collection rate is approximately 80%. Physicians Management Network Inc. estimates the average collection rate for small practices is even higher, ranging from 85 to 95 percent of billed claims.
A high collection percentage is good news but only half the story. Other critical factors include insurance verification and eligibility, timely submissions, effective denial management, coding accuracy, and collection of the portion of payments for which patients are responsible.
How Start-Up Practices Can Thrive Financially
Young and growing medical practices have lots to think about besides finances, so getting some professional help is often a key to success.
For Dr. Chantal Gabriel, who operates Doctors Place in Hackensack, New Jersey, Revenue Cycle Management Services from eClinicalWorks has been vital for optimizing healthcare collections.
“With our previous EHR we did not have the one-on-one services that eCW offers us,” Dr. Gabriel said. “When we started out at that time we had approximately seven claims.”
The problems included a lack of personalized support and no effective RCM solution in place, which meant difficulty in correctly processing claims. That hindered the practice’s growth and operational efficiency.
Powerful Software Plus Weekly Consultations
Contracting with RCM services from eClinicalWorks made an immediate difference. The practice enjoyed personalized, weekly consultations with a dedicated RCM representative, leading to more efficient billing management, more accurate claims processing, and collecting more revenue more quickly. The streamlined patient check-in process and employer health portal further enhanced operational efficiency for the practice.
“Over time we have billed over 120,000 claims through eClinicalWorks,” Dr. Gabriel said. “They have helped guide us, making it easier for us to recoup those claims.”
Examining Every Aspect of RCM for Optimization
It would be hard to overestimate the value of an effective healthcare billing solution. Many practices assume that they can handle their own billing, but once they get caught up in the demands of delivering and documenting care each day, collecting the payments due to them can quickly become a burden.
That’s where Revenue Cycle automation comes in. eClinicalWorks not only helps practices improve the efficiency of their RCM operations but examines areas of healthcare finance that can be easily overlooked.
For example, according to a TechTarget article, it has become more challenging in recent years for medical organizations to collect the portion of a medical bill for which patients themselves are responsible.
An analysis of transactions from more than 1,850 hospitals and 250,000 physicians showed that the patient collection rate fell from 54.8% in 2021 to 47.8 percent by 2023. While patient collections are not the largest piece of any practice’s healthcare puzzle, the reality is that every source of income matters if a practice is to remain financially viable.
A Range of Services to Automate and Optimize RCM
“With eClinicalWorks, we have a dedicated person who works with us weekly to go over numbers, to make sure that we are doing our claims correctly and that we are able to generate the most revenue we can from each claim,” Dr. Gabriel said. “And we’re also taught how to properly do the billing services. So, this has been very helpful in our growth.”
You can hear Dr. Gabriel discuss the impact of eClinicalWorks RCM Services on her practice in this video.
eClinicalWorks offers an array of RCM consulting services to help practices improve financial performance. Our Enterprise Implementation Specialist (EIS) conducts a thorough assessment and gap analysis an develops custom workflows in line with Account Manager Revenue Cycle (AMRC) recommended practices to exceed financial key performance indicators. We also offer Accounts Receivable Lift Service (ARLS) to assist practices needing temporary staff to work new and existing accounts receivable and complete the claims life cycle.
Powerful Software Plus Weekly Consultations
A Range of Services to Automate and Optimize RCM
