Tough Times for Gastro Clinics and Practices
Unpaid dues are bad news for any healthcare practice, and Gastroenterology is no exception. Gastrointestinal clinics across the US regularly face multiple hurdles in handling claim denials efficiently and keeping down accounts receivable from accumulating – impacting both their financial health and compliances.
Every healthcare practice needs a steady flow of revenue. Frequent disruptions in receiving timely reimbursement from Payers can adversely impact the equilibrium of the revenue cycle.
In the realm of Gastroenterology, emerging procedures, newer medication, and ever-changing Payer norms often make getting paid from insurance claims difficult. Claim denials, therefore, are quite frequent, leading to steadily accumulating accounts receivable which can be further attributed to poor follow-ups or a lack of strategy to handle denials effectively.
Before diving into how we ensure streamlined operations and optimized revenue outcomes, let’s first look at some statistics.
- Gastro practices experience an average of 20% denials on claims
- 60% of practices report difficulty collecting payments
- 30 days is the average delay in receiving payment for gastro claims
- Denials and late payments result in an annual avg. revenue loss of $30,000
- $15 is the average cost of processing a single claim
- 10,000 claims are processed annually by Gastro practices
Factors that Contribute to Your A/R Woes
Factors that Contribute to Your A/R Woes
1. Complex Billing and Coding: The intricate nature of gastroenterology billing and coding itself – with its myriad diagnoses and procedures that GI billers and coders often find overwhelming – is a major factor causing denials and compliance issues.
2. High Volume of Claims: The usually high volumes of claims that gastro practices handle on a typical basis, often overwhelm staff and create operational bottlenecks.
3. Denials Management: A high rate of claim denials contributes to revenue loss and puts unnecessary stress on operations.
4. Payment Delays: Prolonged delays in getting reimbursed can impact day-to-day operations and cash flow, often proving detrimental to the smooth running of the practice.
5. Resource Limitations: Clinics often lack dedicated resources for A/R and denial management, which aggravates all the factors above.
Mistakes Impacting Your Gastro Practice’s Bottom Line
Inadequate resources, incompetent follow-ups, incomplete knowledge – these are just some of the deadliest enemies to any Gastroenterological practice, especially if it has unpaid bills piling up fast. We resolve these common issues to safeguard the financial well-being of your healthcare business. Here are some common challenges faced in A/R and denial management, and how we deal with them:
- Allowing Unpaid Claims to Linger: Problem: Unpaid claims tend to pile up quickly if neglected, making them more difficult to recover and ultimately leading to a significant dent in your revenue.
Solution: Utilize our robust system to track and promptly follow up on outstanding balances, preventing bad debt and preserving your profits.
- Letting Denials Go Unaddressed: Problem: Ignoring claim denials, or simply employing a half-baked denial management strategy can result in revenue losses and hinder the financial health of your practice.
Solution: We thoroughly review denials, identify root causes, and initiate appeals when necessary to recover potential revenue and improve overall financial outcome.
- Silent Communication: Problem: Gaps in communication with patients regarding billing procedures and payment options can lead to confusion and delayed payments.
Solution: By clearly explaining billing processes, providing multiple payment options, and promptly addressing patient concerns, we foster transparency and timely payments.
- A/R Expertise Gaps: Problem: In-house resource or staffing limitations can impede effective Accounts Receivable (A/R) management, hindering revenue optimization.
Solution: A strategic partnership with a specialized panel of Accounting Receivable experts will not only optimize your collections but also allow your in-house staff to worry less about pursuing delinquent accounts and focus more on delivering quality patient care.
Get Reimbursed on Time
Engaging a knowledgeable partner to take care of billing & collections is not a new practice. Gastroenterologists have been outsourcing Gastroenterology Accounts Receivable processes to take advantage of a long list of benefits.
We at Sunknowledge offer tailor-made solutions to handle the complete gamut of billing complexities, high claim volumes, denials, payment delays, and resource limitations.
Gastroenterology practices and clinics across the US choose our Accounts Receivable services because our experts consistently ensure high numbers of accounts are touched along with aggressive follow-ups with Payers. This lets us effectively resolve aged accounts, preventing write-offs.
As a pioneer in claims process outsourcing, we implement HIPAA-compliant, accurate, and efficient procedures to supercharge your operations.
Schedule a no-obligation callback to learn why practices and health systems prefer us as their trusted partner.