Decline in Monthly Collections
Q: My average monthly collections has been way off these past couple of months. It's lower than average although my practice doesn't seem slower and patient visits are still average of what is expected. Do you have any ideas or suggestions for why this might be happening?
A: This question could really expand into a much longer conversation because there are multiple possibilities. However, to give you a few suggestions to consider, see below. Either way, it is good that you have noticed this fairly early and can investigate and correct the issue. It is highly recommended to do a thorough evaluation now and not wait to see if things go back to your expected normal. Some possibilities for the decline in cash flow include:
1. Have you recently had a staff change? Particularly a billing person or front desk person? If so, this could be an indicator that there is a meeting and training necessary to ensure that required systems in billing or at the front desk are being appropriately handled. Not to suggest that someone is purposely doing something incorrectly but rather that there is some uncertainty in the department causing oversight or errors that have a direct impact on your cash flow.
2. Even with seasoned staff, things could be happening that should be addressed. Even well trained staff can unintentionally begin to neglect necessary duties. If your office doesn't generally do training and meetings, this would be an excellent component to implement so as to help you keep systems in place, monitor the different departments in your practice and maintain sound systems.
3. Have there been any changes in your community? For example, maybe you have patients that come in from large employers with great insurance coverage and possibly their benefits have recently changed.
4. As you begin to dig deeper to investigate this issue, here are a few things to evaluate:
- Are patients paying copays/coinsurance or other amounts that are patient responsibility at the time-of-service?
- Have you evaluated your billing systems? Billing and data entry could be incorrect. This may include incorrect billing codes, modifiers, not inputting diagnoses, etc.
- Is your software communicating properly with your clearinghouse? If not, you could be having claims rejected before they even get to the payer for processing. If no one is monitoring this system, there could be a lot of potential revenue left completely untouched here.
- Have you evaluated your practice systems for follow-up and appeals? If EOB's aren't being read correctly and/or claims follow-up and appeals is not being managed, this too will disrupt your cash flow.
- Do you have a large number of PI or WC payers? How are these being followed up and what is the status of these claims?
5. What systems do you have in place to properly manage and balance petty cash, patient checks and credit card batching?
Certainly, there could be more to consider than what has been provided in this brief explanation. However, this should provide a good starting point for you and hopefully reveal the source of your problem. Contact us again at www.ChiroCode.com if further assistance is needed.