Year-End Planning for Medical Offices: Reconciliation and Marketing Strategy A Comprehensive Guide to Closing Out the Year Strong As we run through December, medical practices face a crucial opportunity to reflect on the past year and plan. Year-end planning isn't just about closing the books; it's a chance to evaluate your practice's financial health, optimize operations, and prepare for growth in the upcoming year. This comprehensive guide will walk you through the essential steps of year-end reconciliation and help you develop a strategic marketing plan for the new year. Is there anything you should do differently in the coming year? Were there any 2025 strategies that didn’t go as planned? How did 2025 strategies improve over 2024? Did your KPIs trend the way you wanted? Part 1: Financial Reconciliation and Revenue Cycle Review Before planning for the future, you need a clear understanding of your current position. A comprehensive year-end reconcili...
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Why Your Medical Practice Needs KPI-Driven Decision Making (And How to Start Today) Most medical offices track basic metrics like total collections or patient volume, but few use Key Performance Indicators (KPIs) strategically to actually improve their business. There's a difference between reporting numbers and using those numbers to make informed decisions that move your practice forward. From my years as a Director of Revenue Cycle of Hospitals, Clinics, and Consulting with groups of various sizes and now working with dozens of independent therapy practices and medical offices, I've seen firsthand how the right KPIs transform operations from reactive firefighting to proactive management. The practices that succeed aren't just working harder—they're working smarter by letting data guide their decisions. The Problem with Generic Metrics Many offices measure things because they're easy to count, not because they're meaningful. Total monthly collections ...
The clean claim myth
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Clean Claims, the myth! For over two decades, I have heard about the myth of clean claims and a clean claim rate of 98%. So I want to know if this rate of 98% truly exists, and if so, how it is achieved. This morning, while defining KPIs for a client, I audited claims and found instances that did not qualify as clean claims. NDC code rejections from a payer occurred because the fee schedule for that drug wasn't updated from the latest batch provided by the drug company. The payer rejected the NDC code because the fee schedule was updated, but the insurance company hasn't updated its list yet. Patient eligibility was rejected because the patient is a junior, and the clerk didn't add this information since it didn't occur to the patient to mention it. The senior has been deceased for years; why would you ask? The whole idea of "clean claim" is misleading. Are we focusing only on backend issues, or are front-end issues involved as well? Or are we considering ...
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Revenue Cycle and Choosing the Right Vendor: What is the Revenue Cycle, and why do you need a vendor? I wrote this blog after receiving several solicitations this week from offshore companies that want to relieve me of my revenue cycle problems. What makes an excellent Revenue Cycle Management company? It should educate clients. So, I asked the person on the phone what makes their company great. Initially, there was silence, followed by the tired response of “expertise in the industry.” But does that ensure your claims get paid if they lack the staff to work on them or the communication skills to inform your team? Additionally, do they invest time in educating you about training options? Is every interaction confrontational? Do they dedicate time to reviewing reports with clients, or do they even examine the reports? Do they understand how the reports relate to your business, and are they relevant? We have created a position within our compa...
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In today’s highly competitive healthcare market, patients have options regarding where they receive care. If you’re a patient, that’s a good thing. However, if you own or run a medical practice, you know increased competition can work against you. One negative patient experience is all it takes for patients to leave … and never return. The good news? While there is no way to eliminate patient turnover , there are ways to reduce it so your business thrives. Remember, acquiring a new customer costs five times more than retaining one. This financial advantage underscores the importance of patient retention and should motivate you to focus on this aspect of your business. You can’t control whether patients move out of the area or no longer need your services, but you can avoid these six common reasons why patients frequently search for a new provider: #1: The Front Desk. Never has so much money, time, energy, and effort gone i...
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If I only had clarity. One of my clients always told me, "If I only had clarity." She wanted to understand what the number meant. The only sure way to get clarity is to review your data systematically. In today's medical world, Medicare and commercial payors reimbursements are dropping, and the dramatic cost of staffing has increased so much in the last few years, and only if you can find new employees. The need for more intelligent business decisions has never been more critical than today. Gathering the data and correctly correlating and interpreting the data is the science of what KPIs are all about. Employing financial KPIs is crucial for medical offices to track the health of their business, make innovative changes, and avoid knee-jerk reactions. By monitoring these metrics, medical practices can identify areas for improvement, make informed financial decisions, and ensure long-term sustainability. Here are some critical financial KPIs fo...