Finances

How a Revenue Cycle Management Service Saved My Insurance Income

By Emil Fadel, OD

A revenue cycle management partner can expedite the billing process, keeping your office operations running more smoothly and profitably.

I’m the owner of multiple practices affiliated with LensCrafters located in central Texas. As the owner of multiple locations, managing our billing cycle is more important than ever to keep our revenue streams flowing smoothly and accurately. But staying on top of all of our locations had always been a challenge for me.

Before I started using a revenue cycle management service, I was managing our revenue cycle internally with my staff. This came with a lot of challenges. As many eyecare practices know, finding and keeping trained employees can sometimes be one of the hardest parts of the job. Being able to manage a practice’s billing cycle requires a certain type of expertise, and comes with a learning curve for new employees, so dealing with turnover was definitely hurting our revenue cycle.

On top of the turnover, managing the biller’s work, and ensuring that rejections and denials were being addressed, just wasn’t something I had time for with the hectic daily schedule of seeing patients.

In one instance we had two employers who were heavily involved in the billing process leave our office around the same time. After their departure, we uncovered tons of claims that were sitting there waiting to be reworked and resubmitted, resulting in lots of unpaid money for my practice. I needed to be able to have confidence that my billers were managing our reimbursements efficiently and on time. And, in the end, the financial aspects of the practice weren’t being handled as well as they should have with an uneven flow of insurance payments.

This chart is an example of the type of reporting your practice should expect from a revenue cycle management service. The actual numbers on the chart aren’t representative of Dr. Fadel’s practice.

Looking for a Better Solution

At this point, I knew something had to change for me to be comfortable with the way the practice was managing our billing cycle. I started to look into different options for our practice, but was very hesitant about outsourcing such an important piece of our practice.

The biggest factor for me when looking at alternatives was that I wanted to choose a service that was really looking to help me make my business better, and not just a partner that was looking to perform another task and check off another box. Ultimately, I was able to find a service that made me feel very comfortable handing over our billing cycle to them.

Once I was able to find a revenue cycle management service provider that I believed in and trusted, the transition was made easy for myself and my team. It was only a matter of days before the new service was able to start relieving some of the revenue pressures. And within a couple of weeks the new service was fully functioning as if it was another member of my staff. Claims were being submitted the same day as service was provided, and rejections, denials and appeals were all being picked up and re-worked much quicker than before, and best of all, we were bringing in more money faster on our reimbursements.

How RCM Has Helped My Practice

We started using our RCM service four years ago, and haven’t looked back since. Here’s the part where I’m supposed to share with you the hard numbers on how RCM has impacted my practice, but the truth is on a lot of the “before numbers” I couldn’t even tell you what they were – and that was our biggest problem. But I can tell you where my practices are at now.

My bottom line has benefited both directly and indirectly from making the switch. My income has gone up substantially, and the RCM service ends up costing me the same, if not less, than hiring someone to be on site managing the cycle in-house. The service has proven itself a great alternative to trying to manage our billing cycle in-house and dealing with high employee turnover in the biller positon. And I’m paying a monthly invoice rather than someone on payroll – which also helps reduce my payroll taxes.

One of my favorite benefits of my RCM service is the reporting and analytics it provides. The reports generated are able to show me how my practice compares to state and local averages, year-to-year comparisons, denial rates and processing times. It allows me to focus on the big picture and how my revenue cycle is performing. Not only can I measure practice growth, but I’m also able to address the underlying reasons for denials, so I can work to avoid them in the future. In addition, trends and issues are caught much quicker than before.

Having the reassurance that my insurance income isn’t dependent on a single employee, and not having to lift a finger or to worry about what is happening throughout my billing cycle, has given me much less stress, more money, and more freedom to focus on my favorite part of owning a practice – patient care.

Emil Fadel, OD, is the owner of multiple eyecare practices located in central Texas. He graduated from Nova Southeastern University College of Optometry in 2002. And, in 2003 he started his own practice, and has since grown his business portfolio to include multiple office locations. In 2011, Dr. Fadel was recognized as one of Vision Monday’s Optometric Business Innovators.

 

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