By Dhruv Chopra
It’s no secret that the coronavirus has impacted nearly every aspect of businesses, most notably business revenue. While the unemployment rate is slowly recovering, businesses – including radiology practices – will feel the impact of lost revenue for months to come.
With so much uncertainty surrounding this pandemic, patients are continuing to remain cautious about returning to practices and opting out of elective producers and routine exams. As a result, the radiology industry as a whole has been severely impacted as many practices have lost 50-70% of their imaging volumes. What’s more, industry advisors predict that it’s unlikely to see a sharp increase in revenue in the second half of 2020.
While we don’t have all the answers, and it’s hard to say when COVID-19 will end, it is of utmost importance for radiology practices to create a plan of action to recover any lost revenue in 2020. Practices must invest time and energy in finding ways they can improve in order to survive the rest of the pandemic.
In order to move forward during the rest of this pandemic and beyond, leaders need to find ways to accommodate the changing industry. By following the best practices listed below, radiology practices can successfully navigate the changing industry and prepare financially for the rest of 2020, all while cutting costs and improving efficiencies.
Enhancing revenue cycle.
Achieving revenue cycle efficiency is a challenge under normal circumstances with the rapidly moving parts in this industry – add a global pandemic into the mix, and it feels like it’s nearly impossible to achieve. However, it’s imperative for practices to enhance their revenue cycles to avoid further complications in this current business decline during the pandemic.
There may be significant revenue opportunities in both outsourced and in-house billing services. Whether billing is done in-house or outsourced by a third-party, it is important to utilize readily available technology to internally “scrub” claims for the accuracy and completeness required for clean filing. Technology allows for a rules-based review of billing files that is not dependent on a person and triple checks for accuracy before submission. Technology can also help identify opportunities for process improvement to reduce future errors from occurring. Finding a reputable third-party with these solutions already in place can help with implementing them into your day-to-day.
Identifying gaps in billing services.
Another best practice is to start identifying any gaps in your billing services. As the revenue cycle management (RCM) process continues to become increasingly complex, it’s possible that gaps in your practice’s process can result in significant revenue loss or delays. Gaps include incomplete information, missing prior authorizations or lack of documentation. It’s worth noting that no matter how successful your billing operations are, numerous gaps can still go undetected. And, if left unchecked, these gaps can lead to ongoing and compounded issues, resulting in negative financial impacts.
The most successful RCM processes automatically focus on gaps in billing by addressing reasons that are not the fault of the billing function, but rather of the payor. These types of processes are technologically driven and not people-dependent or intensive in numbers. Throughout the pandemic, many in-house and third-party billing solutions have had to scramble to figure out how to decentralize the operation to homes, straining people’s dominant operations as gaps are found. Proper billing services focus on gaps that can prevent any interruption in remote workflow.
Preparing for future business spikes.
We can hope that once the pandemic is neutralized, business will return for radiology practices. This could happen at a rapid pace as those who have delayed routine procedures or screenings are rushing to catch up from previously missed months. That’s why it’s vital to enhance and prepare your RCM process now and prepare for this expected business increase with automated workflow solutions.
Instead of having to work through claims one by one, practices can implement these advanced solutions which allows them to access information the revenue cycle needs with just a few clicks of a mouse. These automated processes monitor and manage the end-to-end billing solutions regardless of vendor, billing system or solution. Through this, they ensure clean and complete information is obtained on the front-end with real-time, data-driven revenue cycle analytics. The end result is a quicker, more accurate way of managing a revenue cycle.
COVID-19 is putting pressure on health care organizations to optimize their workflow and adapt to changing technologies. Providing the right care at the right time and in the right setting has been a goal for practices for many years, and now is their chance to understand what that level of care looks like in today’s fast-paced world. The health care industry – and its technology – is constantly changing and will no longer be the same after COVID-19. It is imperative in this pandemic period that practices review all RCM policies and processes to maximize revenue, which can help manage the remainder of the pandemic and help them be better prepared for the future that will follow.
ABOUT THE AUTHOR
Dhruv Chopra is the CEO of Collaborative Imaging, a radiologist-owned alliance. He previously spent 15 years as an executive with multiple billing companies in the radiology industry where he gained an appreciation for how much physician money is lost due to several inefficiencies. Chopra’s vision for Collaborative Imaging is to create a platform that allows practices to eliminate duplicity that exists between them, thereby allowing efficiencies, cost savings, and best practices to be incorporated amongst its partners.