Medical Practice Operations - Business Fundamentals 101 - 8 Module Webinar Series with Book-255193

255193 - Article 4

Pdf Summary

The document is a comprehensive presentation on the Revenue Cycle (RC) specifically for medical practice operations, conducted as part of a series on business fundamentals in healthcare. The presenter, Jeffrey T. Gorke, serves as the National Director of the Physician Enterprise at Wipfli, a firm offering diverse industry services, including healthcare.<br /><br />The presentation aims to educate attendees about the Revenue Cycle, noting its integral role in the clinic ecosystem beyond just billing. It highlights the different components and their impact throughout different care delivery stages, with suggestions for revenue cycle best practices and procedures.<br /><br />Key aspects covered about the Revenue Cycle include the importance of patient eligibility checks, proper credentialing, and diligent financial collections at the time of service (TOS). It emphasizes the necessity for accurate documentation, coding, insurance verifications, claim submissions, and handling denials efficiently through a structured procedure.<br /><br />Detailed insights are provided on the significance of analyzing fee schedules and "allowables" from different insurers to understand revenue generations and optimize collections, distinguishing between Gross and Net collection percentages and understanding why charges do not equate to revenues.<br /><br />The presentation underscores the value of benchmarking against industry standards to evaluate operations' performance by measuring metrics like Days in Accounts Receivable (AR), collection percentages, and physician productivity. Practical strategies for effective benchmarking, such as avoiding data overload and selecting relevant data elements, are also discussed.<br /><br />Finally, the presentation invites questions for a subsequent module and provides contact details for follow-up. Through this educational effort, participants are equipped with knowledge to better navigate the complexities of managing a medical practice's financial and operational aspects.

Keywords

Revenue Cycle

medical practice operations

healthcare business fundamentals

Jeffrey T. Gorke

patient eligibility checks

financial collections

insurance verifications

benchmarking

Accounts Receivable

physician productivity