Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Practice Management News

Why it’s Important to Select the Right Revenue Management System

By Ryan Mcaskill

San Francisco Sport and Spine Therapy CEO Sturdy McKee talks challenges of upgrade revenue cycle management processes.

This is Part 2 of an exclusive interview. For Part 1, click here.

In an interview with RevCycleIntelligence.com, San Francisco Sport and Spine Therapy CEO Sturdy McKee spoke about the importance of partnering with the right vendor and why a proper revenue management strategy is critical to success. His facility has recently partnered with Clinicient, a revenue cycle management solution provider that specializes in the physical therapy space.

Having the right revenue management solutions is critical for any healthcare organization. Smaller specialty practices like McKee’s operate differently from larger hospitals. His practice is out of network with everyone but Medicare, meaning it needs to abide by Part B rules.

“The combination of lack of coverage and the way the payer and environments have changed around physical therapy and us feeding out of network has increased copays but there are also a lot of people out there with high deductible plans and there are others that are coming to us without any coverage from their insurance and either because it’s one of those high deductible type plans or because they chose to go out of network – they saw the value and the quality that we’re offering, and chose to pay for it,” McKee said.

He added that, for the most part, physical therapy is not a cash business. His practice has to deal with insurance companies and go through the entire claims process. This is something that is important to customer service for the patients and has led the practice to upgrade its management solutions.

When McKee updated his practice management solutions with Clinicient’s Practice Management Software in 2013 and more recently adding the provider’s revenue cycle management product, there were challenges. Aside from choosing the right systems, there was the problem of getting employees to buy in.

“The other big one was internal logistics,” McKee said. “Healthcare providers are a little bit conservative and not super tech savvy. When they get used to something, they want to continue to do that. So, they’re a bit averse to change but there’s a huge immediate benefit. So, getting ourselves on board with the changes and why we were doing it and what we needed to do, was by far, our biggest challenge.”

During the implementation process, one member of each department become a “system champion,” acting as a contact person for any questions.  He added that the vendor has very much been a partner during the process, offering help with any problem and guidance when it is needed.

There were some trends that influenced the decision making process as well. According to McKee, Medicare Compliance and the Recovery Audit Program had a major impact on the decision making process. These audits can be complex and every document needs to be perfect to avoid failing. The practice is now able to use its software and outsourcing to run it own practice audits.

“If we do an audit of ourselves and there are a couple little things here and we need to change – or we didn’t write down the time on this one or whatever, then we need to put them in order to protect us and make sure that that stuff’s done before it’s signed off on and put back in the chart,” McKee said.

Having the right systems in place can make all the difference when it comes to managing a practice successfully.

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