Healthcare practice management is more than just giving the best treatment to patients. Every successful practice has a properly functioning revenue cycle that ensures accurate billing, timely claim submission, prompt payment collection, and proper follow-up on overdue balances. However, several practices fail to make enough profits due to claim denials, billing mistakes, aging accounts receivable, coding problems, and ineffective systems. This is why every health care practice should start with a free revenue cycle audit. The audit helps you understand how well different billing and revenue cycle processes performed and identify opportunities to recover lost revenue.

 

What is the Revenue Cycle Audit?

 

A revenue cycle audit is a comprehensive review of the financial transaction processes in the practice starting from registration and insurance verification moving through coding, claim submission, payment posting, denial management, and accounts receivable follow up.A medical billing audit allows to see where the revenue gets delayed, decreased, or disappeared. Instead of making guesses regarding the performance of the practice, the audit utilizes the existing billing information and shows where the problems lay.A free revenue cycle assessment can be extremely beneficial for medical offices which want to assess their financial status before undergoing some substantial changes or outsourcing their billing to another company.

 

Find Revenue Loss

 

One of the main advantages of carrying out a revenue cycle audit is the chance to find revenue losses.
There are many ways of revenue losses. A claim can be rejected due to the inaccurate identifying of the patient. A procedure can be under-coded. The payer may underpay the claim. The denied claim might never receive any follow-up work. Also, a patient could leave the balance unpaid for months.Though every problem alone seems to be small, when they accumulate, they can have a significant impact on finances.With the help of the revenue cycle audit issues can be identified which will help practice owners and managers understand what funds are lost.

Be Aware of the Reasons Why Claims Are Denied

Claim denials are among the most common challenges in effective medical revenue cycle management. Denials may be caused by eligibility issues, lack of information, mistakes in coding, authorization needs, documentation problems, and rules of the payer.It’s not enough to only monitor An audit of the revenue cycle can reveal denial patterns and assist in pinpointing issues common to your practice. Once any problems are identified, your practice can take corrective action aimed at enhancing claim accuracy and increasing first-pass acceptance of claims.

Assess Your Accounts Receivable.

Accounts receivable or AR is money earned by your practice which has not been collected yet. A high level of overdue AR can cause cash-flow issues for your practice.The revenue cycle audit can involve analyzing the AR of your practice according to such factors as the aging category, payer, claim status, account balance, and collection activity.

This will answer the following crucial questions:

How much money is owed currently?
How much money has been overdue for 90 or 120 days?
Which payers have the largest overdue accounts?
How effectively is your practice managing collections?
How effective is your collection of patient balances?

Taking control of the AR of your practice will enable it to focus on the collection efforts and improve cash flow.

Detect Coding and Billing Mistakes

Accurate coding and billing are crucial for effective reimbursement. Even minor coding errors may lead to claim denials, delayed payments, and revenue losses.

An audit can

When it comes to assessing the efficiency of your current revenue cycle, a free revenue cycle audit is one of the best things you can get.

Some of the key metrics examined in an audit is as follows –

Claim Denial Rate
First Pass Acceptance Rate
Days in AR
Aging AR
Collected Amount in Rev
Turnaround Time of Payment
Clean claim amount
Outstanding amount with the Insurance Co.

The metrics mentioned above give clarity regarding how good a revenue conversion expert one can be in converting services into revenue.

Take better decisions regarding outsourcing

You don’t have to redesign your billing unit every time; sometimes, all problems can arise out of a single process. In other cases, lobar services in medical billing or a full revenue cycle management service can be helpful too.Conducting a free revenue cycle audit first can make the decision making an evidence-based one rather than an assumption based one.You would know the strengths of your internal team if the reports are good; otherwise, you can drill deep into the audit and figure out the gaps that need to be fixed.

What is the benefit of starting with a free audit?

The biggest plus

Begin Your Journey to Enhanced Profits

It is possible for your practice to lose money although you may not be sure of the source of the loss. A complimentary audit of your revenue cycle can expose weaknesses in your billing processes, denial rates, receivables that are too old, coding issues, and other problems with revenue processing.

At TotalMedx, our expertise with revenue cycles enables practices to pinpoint deficiencies that affect billing results, retrieve lost revenue, and streamline the revenue cycle process.

Stop speculating about what is happening with financial losses at your practice, and start the process by having a free audit of the revenue cycle performed.

Frequently Asked Questions

1. What does a free revenue cycle audit include?

A free revenue cycle audit may review areas such as claims, denials, accounts receivable, billing accuracy, payment trends, and revenue cycle processes. The exact scope depends on the practice and the data available for review.

2. How can a revenue cycle audit increase practice revenue?

An audit can identify missed charges, billing errors, recurring claim denials, aging accounts receivable, and other revenue leakage opportunities. Addressing these issues can help improve collections, reduce delays, and strengthen overall revenue cycle performance.