Healthcare reform changes and ICD-10 implementation require new strategies to optimize revenue cycle operations in physician practices.
This article originally appeared in Managed Care Contracting & Reimbursement Advisor, June 2013.
The changes associated with the Patient Protection and Affordable Care Act, electronic medical record implementation, and new Medicare rules mean that physician practices are under increasing pressure, says Nancy Ruff, director of health advisory services for CTG Health Solutions, a consulting company in Dallas. Optimizing your revenue requires clearing some new hurdles and aggressive strategies, she says.
"This is a very challenging time, especially with ICD-10 implementation around the corner," Ruff says. "If they are not efficient right now with their revenue cycle operations, if they are not up to date with their technology, if they don't have good coders in place, they should be very concerned about what to do next and how to stay ahead."
Practices can get so focused on or distracted by one valid goal that they neglect other concerns, Ruff says.
For instance, EMR implementation is important and certainly worth a good deal of your resources, but "we see lots of groups that are in the middle of EMR implementation, trying to achieve Stage 2 meaningful use for those incentives, but they also have to be preparing for ICD-10 implementation," she says. "If they don't get ahead of ICD-10 and plan, test, and train for that on time, they could experience total cash stop page. They could have a total blackout of cash because they're not prepared."