20 WAYS TO GET PAID FASTER

1. 20 WAYS TO GET PAID FASTER THRIVING DURING TIMES OF CHANGE Shelly Guffey 11.15.2012

2. Special thanks to the Medical Group Management Association (MGMA) for use of their data

3. Objectives Discover direct and indirect areas of your business operations that are costing you money Use key benchmarks to help you take action to increase your bottom line Identify technology tools to automate operations, enhance your service to patients and help you get paid quickly and efficiently

4. The Revenue Cycle

5. Where the money goes Staffing is the biggest expense Source: Medical Group Management Association, Cost Survey for Orthopedic Practices, 2010. Report based on 2009 data.

6. Hiring Staff to support your specialty Source: MGMA Cost Survey: 2009 Report Based on 2008 Data

7. MGMA Assessment & Recommendations Evaluate staffing Understand if staffing supports productivity Utilize technology for increased revenue

8. Staffing Turnover Surprise Source: Performance and Practices of Successful Medical Groups: 2008 Report Based on 2007 Data

9. Remove obstacles to provider productivity Minimize time devoted to non-patient care Administrative time Occasions requiring long travel between sites during the middle of the day Time off during peak patient volume cycles Key provider distractions

10. Efficient Staffing Staff to support the busiest time of day Staffing is constant but workflow is not. Result is often overtime! Overtime Regular

11. Efficient Staffing Staff your office based on Schedule Load

12. Key Performance Indicator (KPI) to Measure no show rate Appointment cards given at previous appointment Email reminders and portal tools Snail mail reminders Automated reminders – phone, text, etc. Follow-up file for noting and contacting those who do not keep appointments Tips to reduce no show rate You can’t inventory time!

13. Impact of a high no show rate Case study: 75 pts/day, $85 fee/pt

14. Key Performance Indicator (KPI) to Measure Accounts receivable Percent of A/R >120 days Days gross FFS charges in A/R Adjusted FFS collection percent Patient accounting support staff/FTE physician Total medical revenue per FTE physician Percent of claims submitted electronically Percent of claims denied on first submission Accounts receivable

15. Better performer KPI MGMA Case Study Indicators show opportunities *Includes coding, charge entry, cashiering. Source: Performances and Practices of Successful Medical Groups - 2009; Orthopedic Surgery.

16. MGMA Case Study Gap Analysis What This Means to the Practice An additional $733,466 would have flowed into the practice ($29,338/FTE physician) if the practice had collected like better performing orthopaedic practices.

17. Ways to manage patient payment Review cycle times for claims submission and reimbursement Maintain a date of entry, a date of service, and a date of submission with a practice management system Submit charges on a timely basis Determine time lapse between date of entry and date of submission Process claims more frequently Monitor time from date of submission until date of reimbursement Identify payers slow to process payments

18. Prepare in anticipation of the appointment Verify eligibility, copay and deductible status Automate via batch submission of daily schedule Web-based payer sites issues Note/alert for reception “The further an error travels along the revenue cycle, the more costly revenue recovery becomes. Some industry experts charge a cost of $25 to rework a claim.” Moore, P. “Fix your denial problems,” Physicians Practice, April 2004.

19. Insurance verification Increase patient satisfaction & reduce internal costs *Based on $9.00/hour, $12.00/hour with benefits which is $.20/minute. Generally the hourly rate is higher when performed by RCM staff.

20. 79.67% 65.70% Copayments Collected at Time of Service Better practices collect more upfront Source: Performance and Practices of Successful Medical Groups: 2008 Report Based on 2007 Data

21. Patients’ Share of Medical Bills to Skyrocket 2007: Patients responsible for 12% of their healthcare bills. 2012: Patients will be responsible for 30% of their healthcare bills. • Sources: • Hewitt Associates survey of 340 employers that represent more than 5 million works. Medical Economics, April 17, 2009. • The “Retailish” Future of Patient Collections. Celent.com.

22. Effective Use of Resources: Automate • E-statements • Costs 58% of the price of a paper bill to produce* *Source: Gartner Group, HFMA, and HH&N Research

23. Patient Online Bill Payment Place “Pay online at www.your-practice.com” on your statement Pay a credit card processing fee Processed directly to your merchant account 10% reduction in accounts receivable* Increased cash flow *Source: MGMA

24. What can your system tell you? Performance at a glance

25. Analyze Rejections

26. Tools to Recover Revenue Reimbursement manager Upload claim and remittance data Fee schedule underpayments Misuse of clinical edits Creates formatted appeal letters

27. Better Performers Automate Processes ERA and automated payment posting Improves cash management • Faster, more accurate generation of payment data Faster payment processing means staff get to denial and exception management faster too • No distraction for routine data entry duties Reduced data entry errors Enhanced business intelligence increases profitability that can be measured Source: MGMA Consultant – Rosemarie Nelson

28. Electronic Remittance Benefits Case Study: Saved time = money Days to hours and hours to minutes Payer with 30% of practice’s volume implemented ERA Manual payment posting took 5 days each month ERA reconciliation took 4.5 hours each month Labor savings: $7,668 annually ($1,917 per FTE physician) Source: MGMA Consultant – Rosemarie Nelson

29. Practice check up

30. Falling reimbursement Drop in payment, commercial payers AVERAGE REIMBURSEMENT, 99213 AVERAGE PRICE, HAIRCUT $45 $47

31. Key takeaways Leverage technology Understand industry landscape Take action on daily, weekly, monthly basis

32. Q + A

33. Shelly guffey 800.969.3666 ext1450 sguffey@GatewayEDI.com

34. The Bedside manner your revenue deserves™ Thank you. 11.15.2012