Hello Valued Healthcare Clients and Friends,

As the dust settles from the transition from one year to the next, 38% of Americans begin to wrestle their way to succeeding at their New Year’s Resolutions. Sadly, it is estimated that by the end of January nearly half, or 43% of resolutions, have been set aside. By the end of the year, it is generally said that less than a tenth of those who set a resolution will accomplish them. These stark numbers provide an opportunity for us to examine why there is such a gap between keeping or abandoning the noble pursuits we set for ourselves at the start of each year.

The new year is a perfect time to set specific goals in your personal lives but it also provides the opportunity to set (or reset) goals for your practice as well. Here are three possible things to consider as you sift through what you would like this year to look like for your practice.

1.  Compliance

Audits, cyber-attacks, and HIPAA breaches, oh my. There is no doubt that compliance for healthcare practices is a tricky business to navigate well, and there are many components of a robust compliance program to consider implementing. Do your cyber security protocols adequately protect your patient’s data? Have you performed a Security Risk Assessment to find vulnerabilities in your practice? If not, the new year is a great time to re-assess your cyber security.

Your providers work hard for the revenue you see come into the practice. They document, discuss, and dictate their way through each section of every patient’s chart. ICD and CPT codes are assigned, bills are submitted, and reimbursements are processed. Then, an audit notice arrives in the mail and suddenly that hard earned revenue is at risk. External chart reviews serve to not only protect the revenue that your providers have worked so hard to earn, but the many procedures that have been documented but not billed can be identified, submitted, and reimbursed. When it comes to compliance, WebsterRogers has a team to help you implement external chart reviews and ensure your revenue is well protected.

2.  Reimbursements

Speaking of reimbursements, when was the last time you renegotiated your payer contracts? If the answer for any one of them is greater than three years then there is likely money being left on the table – the payer’s table. This is money that the payers are all too happy to leave on the table and will silently allow your contract to automatically renew year after year with no rate increases. Your providers work hard to earn the revenue from every patient visit and don’t you want to maximize how much return they get on each encounter? WebsterRogers has a team of experts to help you ensure that you are receiving the best rates possible.

An increasingly common method of reimbursement for practices is to receive remittances via virtual credit cards. While convenient, virtual credit cards pass on the processing fee, usually 3-5%, to the recipient. This means that overall reimbursement for these payments is reduced by 3-5% without ever adjusting the contract. If you notice reimbursements being paid via a virtual credit card, WebsterRogers has consultants to help you reverse this and restore your reimbursements.

3.  Expansions

In 2023 the state of South Carolina repealed the Certificate of Need for healthcare entities. This single piece of legislation opened the door for every practice, hospital, and Ambulatory Surgery Center to pursue their dreams of building and expanding in new areas. This is not, however, without pitfalls. An expansion project without due diligence and a well thought out strategy is doomed to fail. As Benjamin Franklin is credited with saying, “If you fail to plan, you plan to fail.” WebsterRogers has a team to help you plot a course for your expansion plans.

While expanding your practice’s footprint provides its own challenges, so does expanding your roster. Licensure, credentialing, malpractice insurance, and a myriad of other tasks must all completed while not pulling away from the practice’s daily operations. It’s no surprise that onboarding a new provider is dreaded by practice managers around the country. WebsterRogers has a team here to help you make this process as smooth as possible so you will look forward to onboarding the next provider.

Don’t let this year be the one that got away. Make it count by safeguarding your practice with a robust compliance program, maximizing your reimbursements, and getting the support you need for a smooth expansion. Reach out to our consulting team to schedule a call today.

Contact our Healthcare Services Team for more information or to get assistance: websterrogers.healthcare@websterrogers.com.

Sources:

Norcross JC, Vangarelli DJ. (1988–1989). The resolution Solution: longitudinal examination of New Year’s change attempts. Retried from https://www.ncbi.nlm.nih.gov/pubmed/2980864