Practice Management

How We Modernized to Reduce Accounts Receivables 30%

Dr. Hitchmoth in an exam room in her office. Dr. Hitchmoth says that, in addition to providing patients with a better experience in her office, modernizing has also helped reduce the practice’s accounts receivables.

Modernizing your practice to improve patient care and business operations.

By Dorothy Hitchmoth, OD, FAAO, ABO, ABCMO Dipl.

Sept. 20, 2023

Do you give patients an experience as modern and seamless as what they experience in other businesses? And have your business operations kept pace with modernization? Here’s how to ensure both patient experience and back-office operations are thoroughly modern.

What is a 21st Century Practice?

A true 21st century practices delivers services and products that transcend traditional offerings, improve public health, prevent vision loss and support both primary and sub-specialty care. To do that, you need technology and processes that improve practice efficiency, help identify early eye disease, support your work teams and improve profitability.

You May Need to Audit & Update Your Revenue Cycle Management

Eyecare is a critical front-line healthcare service that has already evolved to meet the needs of a diverse, aging population in light of doctor shortages and third-party payer reimbursement reductions. This means optometry will be responsible for a growing number of medical visits. Medical eyecare is large component of rural and suburban practices now, and this will expand to all communities that optometry serves. These facts bring revenue cycle management (RCM) front and center.

Using technology to manage RCM for medical claims processing and patient accounts is critical. Leaving money “on the table” is not an option given the downward pressures in reimbursement. “Writing off” medical visits to capture vision exams has significant legal implications and devalues your skills as a doctor.

I also recommend that private practice owners fully understand all aspects and details of their RCM system before deciding to outsource billing or delegate to employees. Once you achieve a detailed systems understanding, you can delegate away! Learning all aspects of medical billing is a key component of serving the public and paying yourself.

In our practice, we drastically improved insurance and patient collections by fully utilizing a software system ALREADY in place. This required significant work, but was easier than the daunting task of switching EMR/RCM systems to an entirely different platform, and the results were better than turfing the task to an external billing expert. We did this by performing a top-to-bottom lean operations audit of our revenue cycle processes while learning all aspects of the robust reporting platform.

The audit resulted in the identifications of a few key areas of repeat errors that ultimately represented over 90 percent of the arrears.  Despite hiring many  professional billing services in the past, we learned they had little incentive to improve our internal process errors. Learning all aspects of our RCM software was a key investment of time that has ultimately resulted in a 30 percent reduction in AR translating into thousands in increased revenue per month.

This process audit also resulted in a significant reduction in billing service costs because we were able to identify simple steps that current staff could perform. They are able to create detailed reports supported by artificial intelligence that quickly identify claims rejections and other errors. This streamlined billing management takes an approximate total of four staff hours per week and enabled us to end our contract with our professional billing service, which also improved our profit margin.

The total doctor time to run an analysis each week is about 15 minutes, and AR assignments are made quickly. More importantly, we assign claims rejection corrections and zero dollar claim payments to the staff members that do patient intake, so they learn the importance of the details they are responsible for.

Improving Revenue Cycle Management Just One Part of a Larger Picture

Revenue cycle management is just one aspect of running a successful business. If you are not sure how to improve your business acumen, start with a mentor or expert consultant.  You spent years developing your skills as a doctor and that required dozens of mentors. Repeat this process in business and find the right people to help you refine your success. Be sure to take a systemic approach to diagnosing your business woes.

Remember, as practice owners we need to continuously evolve. Revenue cycle management is just one area to consider for focus, but it’s an important one. Transformation does not happen suddenly, so take it one step and day at a time. Helping patients and your community while running a successful business does not need to feel overwhelming. Small changes over time matter. You need to decide to lead your team. The investment in time can improve your quality of life too.


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Dorothy Hitchmoth, OD, FAAO, ABO, ABCMO Dipl., is the owner of Dr. Dorothy L. Hitchmoth, PLLC in New London, N.H. To contact her:





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