Survey: Many medical practices missing opportunities to optimize revenue

Many medical practices do not achieve practice revenue cycle management benchmarks and are potentially missing opportunities to optimize revenue, according to a NextGen Healthcare Information Systems revenue cycle management survey.

NextGen conducted the survey, called What's Happening Behind the Billing Office Door, among several hundred medical practices in 40 states spanning various specialties, staff size and locations, including NextGen Healthcare Clients and non-clients. The survey evaluated various high-level metrics, including net collection percentages, first-pass clean-claim rate, average days in A/R and outstanding collections for 120+ days.

Highlights from the survey are shown below:

1. The use of automation in the revenue management process was popular among practices that handled billing in-house and those that outsourced, especially for claim scrubbing (65 percent of practices) tasking staff with A/R and denial follow-ups (55 percent) and automatic appointment reminders (47 percent).

2. While 77 percent of medical practices have between one and 10 employees working in the billing office, nearly half of the practices reported there is only one person responsible for handling the denial resolution process.

3. Only 15 percent of survey respondents rated their practices' denial follow-up and resolution abilities as excellent, and just 4 percent rated their ability to ensure all electronically submitted claims make it to the carrier as excellent.

4. Confidence in billing professionals' preparation for ICD-10 was drastically different among practices. Twenty-one percent of practices said they were "very confident," 50 percent were "somewhat confident" and 23 percent were "not at all confident" in their ICD-10 preparation.

5. A little over a third of practices enter charges into the system within one day of patients' visits, and 35 percent have implemented a credit card program as an option for patients to pay.

6. Nearly half — 46 percent — of practices estimate heir net collection percentages were in the 70 to 80 percent range. About 30 percent selected estimates in the 91 to 100 percent range.

7. The overall average number for average days in the A/R was 35.

8. Most survey participants — 62 percent — said their practices' percentage of outstanding collections for dates of services older than 120 days fell between 1 and 20 percent.

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