Whether during periods of intense business activity, or during a crisis like the current pandemic, which has affected economies globally, efficient medical billing is the only way to ensure year-round financial sustainability for DME/HME businesses. For startups and small businesses, with just enough cash to cover two weeks’ worth of expenses at any given time, smart revenue management holds great significance. Revenue management may begin with diligent bookkeeping and accounting practices, but there are ways to improve the overall revenue management cycle.
The need for accuracy and reliability
An online report by Patient Engagement HIT describes the frustration that 70% of patients feel when asked about billing and financial responsibility. A survey in the article reveals that a healthcare organization that simplifies payments is attractive to patients. Healthcare professionals spend a significant amount of time and money completing forms and processing essential paperwork for insurance. For a startup DME/HME, this can mean time away from providing healthcare to patients. Less time focusing on patients can cause existing goodwill to erode, while hindering prospects of new business that may come through referrals. Lack of adequate new business can in turn prevent the DME/HME from generating the income needed to ensure business sustainability. Improving the revenue cycle is critical. Establishing efficient financial management or medical billing systems can help.
Here are some considerations for DME/HME businesses attempting to improve the revenue cycle.
- Define services clearly to avoid missing payments
Unless services are defined and clearly outlined, startups and small DME/HME businesses will have difficulty including them into the overall business plan or allocating necessary investment for maintenance. More importantly, a lack of well-outlined services can lead to patient misunderstandings. When patients receive an invoice, they may assume that payouts are bundled.
Services can include insurance mandates such as prescriptions, details specific to the offered service, and a payment component. If services are agreed to verbally, instead of in writing, it is prudent to conduct an analysis of costs involved in comparison with the level of healthcare required.
- Understand the patient profile
Patient profiles include details on health insurance providers. Organizing patients by insurance providers is one way a DME/HME business can more easily access information at the time of claim application and claim processing.
Patient profiles also include a diligent recording of key medical documents, such as advisories, prescriptions, and notes from doctors or nurses recommending a particular line of treatment, including the use of accessories and equipment.
- Manage patient costs efficiently
If capitation payments are involved, ensure they are categorized so that the system keeps track of the accounts receivable at all times. This helps the caregiver to provide uninterrupted services, while ensuring the patient isn’t inconvenienced. Ideally, automation of systems can greatly help capitation because they can be programmed to alert the DME/HME if a certain type of claim falls under the category of capitation.
Understanding costs at all levels of business is important to foster patient trust and prevent payment delays. Tracking costs is easier when the insurer’s responsibility is clear and the clinical data, including medical records, is well documented. Ideally, billing and payments tracked together can provide reliable insights on operational efficiencies to DME/HME businesses.
Keeping healthcare delivery prioritized
Healthcare delivery can leave patients feeling dissatisfied even as DME/HME businesses are trying their best to ensure little to no gap between demand and supply. This is especially important in the time of COVID-19, when lockdowns negatively impact transport and delivery of essentials. Investing in proven healthcare management systems, including medical billing systems, is vital to ensuring business sustainability and prospects for future growth.