Like any other medical specialty, women’s health practices depend on an efficient and error-free revenue cycle to maintain financial stability. But all too often, there are obstacles that make that difficult for practices – from evolving regulatory requirements and procedural changes to inefficiencies caused by staff turnover. Revenue cycle balls get dropped, and the result can be detrimental to practice growth.
For OBGYN practices, outsourcing revenue cycle management can help overcomes those challenges – speeding up payments, reducing claim denials, decreasing days in A.R. and improving the overall patient experience as well.1 Here’s how:
Hurdle #1: Escalating Claim Denials
Unresolved claim denials result in an average loss of $5 million annually for practices, nearly 5% of net patient revenue – and that number continues to grow each year. Initial claim denial rates have consistently risen in recent years – from 9% in 2016 to 12% in 2022.2 The impact of that on your OBGYN practice is substantial.
High rates of claim denial, which can often be attributed to coding errors, disrupt practice’s cash flow and increase administrative workload. Incomplete documentation and eligibility issues also can contribute to high denial rates, which can lead to delayed payments, straining practice resources and pulling focus away from patient care. Your practice’s overall efficiency and cash flow could be negatively affected. Outsourcing revenue cycle management to a partner like Accurio helps overcome those challenges and ensures denials are resolved quickly so cash flow remains steady.
Hurdle #2: Lengthy AR Days
Challenges with accounts receivable and the payment delays that come with that can have a significant impact on cash flow for women’s health care practices, making it difficult for the practice to manage its operational expenses and focus on patient care. This payment lag also increases administrative burden, escalating the time staff members spend following up on outstanding claims and performing payment reconciliation. How much is too much when it comes to days in AR? The industry standard is 40 days or less.3 If your average is longer, it likely indicates issues with practice billing or collections processes. Accurio specializes in helping OBGYN practices pinpoint and address the causes of lengthy AD days. Interested in learning how? Find out.
Hurdle #3: Insurance Eligibility Verification
Ensuring that patient coverage verification is updated and accurate can be time-consuming, but it’s especially crucial for obstetrics and gynecology practices. Inaccurate eligibility information can result in insurance claim denials and a delay in payments being issued, which can affect your office’s cash flow. Insurance plans vary in complexity, which means careful attention to detail is required during the verification process. This needed attention increases the burden on your practice’s administrative staff and can potentially lead to inefficiencies in the billing process. Learn how Accurio helps women’s health practices navigate these challenges with no disruption to office workflows and no long-term commitment: Discover now.
Hurdle #4: Evolving Billing Codes & Regulatory Requirements
Benjamin Franklin famously said that nothing in life is certain except death and taxes. We would add ongoing updates to regulatory requirements and procedural codes to that list. Keeping up with this endlessly revolving door of changes is something many practices struggle with, and not doing so can have substantial consequences. Coding errors often lead to billing inaccuracies, delayed reimbursement, and the added expense of additional resources when claims have to be adjusted. These types of errors in coding compromise not only an OBGYN practice’s financial performance, but its efficiency and patient satisfaction as well. Continual training of internal billing staff on new regulatory requirements also creates a burden for practices. Partnering with a revenue cycle management company like Accurio helps offset that burden, ensuring practices stay in compliance, claims are processed correctly and billables are maximized.
Maintaining a sustainable and efficient revenue cycle takes time, expertise and resources that busy practice staff may not have available. Outsourcing your practice’s RCM can help overcome those challenges, especially when you partner with an expert in OBGYN revenue cycle like Accurio.
Schedule a consultation to learn how Accurio’s women’s health revenue cycle management solutions can help your obstetrics and gynecology practice see sustained growth and profitability.
Sources
- Revenue Cycle Management: The Art and the Science. (2024, July 2). PRS Global Open. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11219169/
- Why private practices need a stronger handle on the revenue cycle. (2024, May 20) American Medical Association https://www.ama-assn.org/practice-management/private-practices/why-private-practices-need-stronger-handle-revenue-cycle
- AAFP.org
