One of the first steps to optimizing the revenue cycle for a Pediatric Practice is to develop and incorporate a consistent Billing Processes, Procedures and Policies Manual for the practice. This manual should be customized to the practice based on how the revenue cycle is managed for the Pediatric Practice. Some items to include in this manual are:
• Payment Plan Agreement
• Examples of letters that will be used for final collections, payment plan, etc.
• List of responsibilities for front desk team members
• Registration forms
• Notices such as privacy policy
For all of our new billing clients we develop or edit the Billing Processes, Procedures and Policies Manual to the needs of the practice. This written document helps to provide clarity to all parties involved related to the Processes, procedures and policies for managing the revenue cycle of the Pediatric Practice. Developing and implementing this manual is an important first step to optimizing the revenue cycle for the Pediatric Practice. If you develop your own manual, recommend you obtain assistance from either a Pediatric Practice consultant or from another Pediatric Practice Administrator to identify if the manual is within the current standards of the industry. We have obtained new clients that were managing the practice based on revenue cycle rules of the late 1990s. In some of these cases, the practices were missing thousands of dollars a month in unrealized revenue due to outdated practices and processes.
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Does Your Pediatric Practice have a clear and consistent Billing Policy Manual?
Some Potential Effects on Pediatric Care due to September 11th, 2001
My 9th grade daughter asked me, as an assignment for school, where I was and what was my first reaction when I learned of the news related to the tragic events of 9-11-01. Most of us whom were adults at the time could describe the exact location and what we were doing when we learned this shocking news. The tragic events of this day changed many things in our country. What are some of the potential additional treatments in Pediatrics due to 9-11-01? The answer to this question is that it depends.
If you were a Pediatrician in New York, NY, you might have children that had early development of asthma. The Pediatrician would need to do a detailed history to see if there is any link to the events of 9-11-01. Where was this patient on 9-11-01? Where their parents exposed to the debris and air associated with 9-11-01? Asthma is not the only disease that the Pediatrician needs to complete a detailed history. Other potential diseases such as acid reflux, depression, anxiety, or sinus congestion might also might have a link.
Today is a day to remember the tragic events of that day as well as to remember our brave fire fighters, police officers, and other public servants that risked their lives to help others in a difficult situation. Although 9-11-01 was 11 years ago, the negative impact is still felt today.
How Aligned are your consultants to the Goals of Your Pediatric Practice?
A Pediatric practice needs to successfully work with both internal and external stakeholders to be successful. These stakeholders include employees and external vendors/companies and sometimes, consultants. There can be misalignment of the goals of each of these stakeholders with the goals of your Pediatric Practice. There are a number of questions to ask a consultant to insure they represent your best interests.
Some of these questions could include:
-Is the consultant recommending a product or service due to an alliance with their firm or due to quality of the product for your practice? For instance, a company that sells servers will have a bias to recommend server E.H.R. systems due to their revenue being made based on providing advice and maintaining servers. If a consultant speaks at an event sponsored by a Vendor, this might indicate that there is a bias for this vendor. A question to ask: Is the speaking engagement with a particular vendor due to the vendor providing them customers that they can charge their consultant service and do they speak equally at events for all vendors in the same state (not just the ones that send them practices)?
-Having a consultant choose an E.H.R. service, could cause a Pediatric office to obtain an ‘old’ technology product or a product that does not appropriately balance the revenue/cost needs of the practice with the desire for a consultant to provide a service. Some consultants might not have the technical expertise to make the ‘right’ decision for your Pediatric Practice. Recommend asking any “E.H.R. consultant” how long they have managed a practice as well as their experiences with optimizing revenue for a practice (there are many with great experiences and unfortunately some with none to minimal experience). Equal time should be spent discussing the revenue cycle/practice management as well as clinical aspects of the E.H.R.. Consulting advice should look to optimize revenue, minimize burden, cost and start-up time. The practice is ‘on the hook’ for long-term operation of a system/process and the receiving end of decisions made regarding a system.
-Does this consultant make more or less money if the practice identifies a solution that requires minimal work on their part? Why would a consultant that charges by the hour (whether paid for by the practice or the government) seek a system that reduces billable hours? The long-term operational burdens are the responsibilities of the practice not a consultant.
Exceptional consultants with a solid history should be able to balance the needs of their clients with the need to optimize their own billable hours. Great consultants know and understand the revenue cycle and provide hints on how to reduce administrative burdens of Pediatric Practices. With all the conflicting priorities and needs of a Pediatric Practice, it is important for a practice owner to select the ‘best’ consultants/advisors for their particular needs.
