Running an ear, nose, and throat practice comes with its fair share of clinical and operational complexity. But beyond delivering quality care, providers must also maintain a healthy bottom line, and that starts with effective ENT revenue cycle management (RCM).
RCM for ENT involves every step of your practice’s financial process. It begins with patient resolution and ends with collections or denial resolution. Without the right systems in place, you run the risk of shrinking profit margins and delayed payments.
Here’s how to modernize your approach to revenue cycle management for ENT so you can position your practice to thrive.
Revenue cycle management for ENT is rife with challenges.
ENT services often involve bundled services and procedures. This makes coding more prone to errors. Mistakes in CPT or ICD-10 codes frequently result in denials or underpayments.
ENT RCM is even more complicated due to varying denial trends between different payers. One payer may frequently kick back certain procedure codes unless you provide additional documentation.
To improve revenue cycle management for ENT, you need a way of tracking these trends and holding payers accountable for recurring underpayments.
High denial rates, especially preventable ones, slow down payments and increase admin time. Before you know it, your ENT practice is racking up a ton of extra labor hours, and billing employees will get burnt out, all while cash flow is disrupted.
Adopting tools that support revenue cycle management for ENT provides a clear path forward. You will be able to efficiently track and resolve these denials at their source. This is particularly important when the source is your processes.
ENT RCM also involves collecting money from your patients. This has become increasingly important due to the rise in self-pay patients. ENT clinics face mounting pressure to collect payments up front. That needs to be a priority for your practice, especially for elective or cosmetic procedures.
Think about how many payers your ENT practice works with. Each of them has different rates, terms, and reimbursement schedules. If you have no way of tracking all of these contracts using a centralized database, it’s nearly impossible to see when you’re underpaid or negotiate better rates.
Download an ebook and learn how to overcome these ENT RCM challenges.
Strong ENT RCM processes eliminate the clutter of paperwork and directly improve the performance of your practice. You can use revenue cycle management solutions to:
Where do you start? Watching the right revenue cycle management metrics will help you identify opportunities for improvement and where you are falling short. Once you know where you can get better, you need to implement solutions that empower you to achieve those goals.
Are you ready to rethink how you handle revenue cycle management in your ENT practice? Here are some best practices to help you promote stronger cash flow and long-term revenue growth.
Winning at ENT RCM begins with accurate coding. Use ENT-specific coding guides and train your team on the intricacies of the services your practice specializes in. This reduces errors and will increase your first-pass acceptance rates.
Keep in mind that improving coding accuracy takes time. There aren’t any quick fixes. Focus on tools that will provide some short-term impacts while you work toward your long-term acceptance rate goals. Collaborate with your coding team to address the specific challenges they are facing.
Identify opportunities to automate claim submissions and denial management workflows. The more of these processes you can automate, the more time you will save and the lower risk of human errors. Automation also helps you organize and batch denied claims for faster resolution.
As part of this process, you should also be asking, “What is a good collection percentage?” Focus on automation efforts that will help you reach your target collection percentage. The more efficient you can become, the stronger your cash flow will be.
Use tools to compare payer reimbursement rates and identify underpayment trends. This helps you renegotiate contracts from a position of strength and optimize reimbursements.
With the right tracking tools, you can turn negotiations on their head. Traditionally, payers hold all the cards. However, if you can show how they are failing to fulfill the terms of their agreement, you can push for better terms that protect your bottom line. Put the power back in your hands with modern ENT RCM technologies.
Offer clear, upfront pricing to your patients. You should also offer several different payment options so that more patients will pay on time. This improves patient satisfaction and reduces the risk of disruptions to your cash flow.
Your RCM team doesn’t have time to waste on low-value collections, but you also cannot afford to let those payments go by the wayside. When possible, collect patient payments up front. Doing so will help you break the collections cycle and stop chasing down copays or deductibles.
Check out this on-demand webinar to learn how to maximize cash flow and win at revenue cycle management for ENT practices.
Healthcare revenue cycle management solutions from Rivet accelerate ENT RCM workflows. Our easy-to-use RCM technology enables you to:
Are you ready to see how our tools can transform your ENT RCM? Schedule a demo with Rivet.
