By Anthony Vecchione
Effective revenue management is key to the growth and sustainability of any business. A winning revenue management strategy goes way beyond sales and marketing 101. Frank Leone, president and CEO of RYAN Associates, said that revenue management also means not losing revenue that you already have and keeping revenue on the table. “A lot of revenue management is simply generating it and noticing where your greatest profit margins are,” said Mr. Leone. What are the keys to a successful revenue management strategy? Financial micro-management is one of the most important, and oftentimes, least favorite jobs of some occupational health program managers, said Roy Gerber, senior principal at RYAN Associates. “By developing a structured approach to evaluating and monitoring the key areas of your program’s practice management, the task can become less onerous,” Mr. Gerber said. He added that by developing guidelines for functions like revenue cycle flow, staffing, expense management, billing and collection, and calendaring a schedule for review, the job becomes more manageable. For example, on a quarterly basis one might review accounts receivable. By identifying the areas to be monitored and the frequency of review in advance, Mr. Gerber said it becomes easier to stay organized and to effectively monitor and improve financial performance.
CODING/DOCUMENTATION
Donna Lee Gardner, R.N., senior principal at RYAN Associates, said it is important to know the documentation standards of the American College of Occupational and Environmental Medicine (www.acoem.org). “They tell you how to document an injury that meets the Current Procedural Terminology guidelines. If you don’t know and set up your templates inappropriately, you are not going to code appropriately and you are not going to get paid.” Ms. Gardner said many people get confused, especially in a hospital, and place Medicare and Medicaid guidelines on these documentation parameters for CPT coding. “You are billing workers’ compensation, not Medicare or Medicaid.” According to Ms. Gardner, it is important to know the standards and the standards say that 85% of initial evaluations in an occupational medicine injury management program are going to be coded a level four if all of the appropriate documentation is Provided. “If you document right and are coding appropriately, your accounts receivable should be fine. For example, you should be able to get a workers’ compensation bill out the same day,” said Ms. Gardner. Pittsburgh-based NetHealth (www.nhsinc.com) is in the business of developing electronic medical records software for the outpatient specialty care market. Its president and CEO, Anthony Sanzo, said the company’s success is tied to the success of its clients, i.e., healthcare providers…including doctors and other clinicians.
“Why are we interested in offering revenue cycle management to those of our clients who do their own billing and collection? Because they need it. They can’t do what they want to do unless they have an efficiently run and cash generating organization.” What has been effective, according to Ms. Sanzo, is having a good clinical practice management application that allows the whole process to start at the very beginning of the patient’s encounter. “What makes a good revenue cycle management system work well is getting that information collected electronically early on,” Mr. Sanzo said.
Revenue Management will be the topic of course #12 at RYAN Associates’ 28th Annual National Conference with Don St. Jacques, Joseph Marty, and Anthony Sanzo serving as faculty.
