There are several major
financial pressures that affect physicians today, from collecting co-payments
to rising technology and operational costs. The year 2015 has proved
particularly challenging with the cost of ICD-10 and financial penalties for practices
that could not attest to meaningful use.
The table below details five
financial pressure points facing physicians in private practice today and the solutions
to help mitigate these pressures.
|
Pressure Points
|
Solutions
|
|
Co-pays & Deductibles
|
·
Have the receptionist discuss payment with patients at
pre-registration before entering the office.
·
Collect co-payments at the time of service.
·
Implement online and mobile payment processing.
·
Schedule automatic or recurring payment plans that collect from bank
accounts, debit cards, or credit cards.
·
Ensure the patient’s ICD-10 codes are accurate to prevent Medicare
and Medicaid denials of payment.
|
|
Claim Denials
|
·
Develop and implement a pre-billing checklist to prevent errors.
·
Develop and implement a claims manual that documents the requirements
and nuances of every insurance carrier in which the practice has a
relationship.
·
Consider dropping insurance altogether and becoming a private pay
practice.
|
|
Technology Costs
|
·
Use low-cost or free EHRs.
·
Use cloud-based EHRs and billing systems to prevent against data loss
and upfront costs of new software and computers.
|
|
Rising Operational Costs
|
·
Implement extended hours to grow revenue.
·
Devise a patient check-in kiosk to streamline patient flow through
the office.
·
Emphasize communication, education, flexibility, and understanding of
the practice’s needs to employees so they may perform at a higher level.
·
Employ non-physician providers to see patients during regular and
extended office hours.
|
|
Pay For Performance
|
·
Report Physician Quality Reporting System (PQRS) data to the Centers
for Medicare and Medicaid Services (CMS) in a timely manner. Ensure the data
conforms to CMS’s guidelines.
·
Consider joining a shared savings program, such as an accountable
care organization (ACO).
·
Under an ACO, contract with a payer to provide care to a designated
patient population during a set time period while meeting agreed-upon quality
and cost benchmarks.
|
|
Maintenance of Certification (MOC)
|
·
The application fee for the MOC program is upwards of $1,000.
·
To better understand the program’s costs and requirements to prepare
for examinations, the American College of Physicians (ACP) has developed the
interactive tool ACP MOC Navigator, which is available at
https://www.apconline.org/mocnavigator/.
|
As the table
demonstrates, there are workable solutions to help overcome the financial
challenges physicians in private practice face today. Additional tips for
collecting co-payments include reminding patients before their appointment that
a co-pay will be due at the beginning of their appointment and informing the
patient of the estimated costs of service. If payment is an issue, offer a
payment plan to the patient prior to the patient leaving the office. All office
staff should be knowledgeable of the practice’s fees, procedure costs, and
payment options, as some patients may feel more comfortable speaking to a
medical assistant or nurse than the physician about payment. Always address
patients by name and let them know they are valuable to the practice; this
helps facilitate a positive discussion about payment.
“The economics
of medicine are changing at a rapid pace. It’s important for physicians to
remain abreast of these changes in order to keep their practice doors open,”
says Dr. Cockerell.
Please read the
article Pressures Private Practice
Physicians Face Today to learn more about the general challenges physicians
in private practice face today.
References
Cockerell, C. (2015). Lessons for
Dermatology from the Tao Te Ching.
Retrieved September 28, 2015, from www.dermpath.com.
Medical Economics (2015). Top 15
Challenges Facing Physicians In 2015. Retrieved September 24, 2015, from http://medicaleconomics.modernmedicine.com/medical-economics/news/top-15-challenges-facing-physicians-2015?page=full.
Medical Economics (2015). Top 5
Challenges Facing Physicians In 2015.
Retrieved September 24, 2015,
from http://medicaleconomics.modernmedicine.com/medical-economics/news/top-5-financial-challenges-facing-physicians-2015?page=full.
