Many South African medical practices are bleeding revenue & they don’t even know it. It’s a phenomenon that we call a ‘normalised pain state.’ This state is characterised as a business that is quietly losing revenue (& viability), but the loss goes unnoticed or disregarded as a problem by the practice owner.  

Sound familiar? If your practice is meeting expenses every month, you’re paying overheads & salaries – including your own – what’s the problem, right? The trouble with a business that’s operating in a ‘normalised pain state’ is that any change to the status quo puts your business & your livelihood at unnecessary risk – think COVID. 

Let’s look at 4 key areas you can look at to determine whether your medical practice is stagnating in silence & what you can do about it.

 

Your patient volumes

How many patients do you see on any given day? How about on a monthly basis? If you can’t answer both of these questions, a bigger problem is at play. 

Knowing your average patient volumes is much like forecasting – you are using your data to predict & (better) manage your cash flow. Patient volume data also helps you to get an idea of your expected revenue for the month.

The fix

Are you underestimating your practice’s potential revenue by not knowing your patient volumes? Use a practice management solution that generates useable business insights reports so you know your actual patient volumes at a glance.

Your patient volumes vs benefit checks performed

Do your scheduled appointments reflect the number of patient benefit checks sent? Most patients don’t understand how their medical aid works or what they are covered for. Nothing is more triggering for a patient worried about money than to get an invoice higher than expected after their visit. 

If your staff are not performing benefit checks, you need to check the impact of your bad debt on your revenue potential. Patients who are confirmed medical aid members & informed about any co-payments before their appointment are much more likely to pay their bills or make a payment arrangement before leaving your practice.

The fix

Use a practice management solution that performs automated patient benefit checks on every patient booked in your calendar. It reduces the time & effort of sitting on the phone trying to manually confirm a patient’s membership & available funds. Not only that, but if a discussion about money needs to happen – your staff can do so before the patient arrives for their appointment.  

 

Your patient volumes vs actual claims sent

How often do you check your claims rejection rate? Do you have a valid claim response for every patient you see?  Can you put a number to how many claims go stale or get lost? 

Sending claims can be complicated or even onerous if you do so manually. But claims are revenue & essential to staying in business. Losing or not sending even just 2 claims a month can equate to R12 000 in lost revenue per annum. 

The fix

Sending claims retrospectively is one of the top contributors to lost revenue. If you want to reduce (or altogether avoid) lost, stale &/or rejected claims, you must send claims in real-time. And not only in real-time but also in a billing system that integrates with your clinical notes system. With an integrated solution in place, your staff receives the correct information straight from your billing instructions to generate a claim at the time of service.

 

Claims sent vs revenue received

Does the revenue in your bank account equate to the value of the claims sent in that month? If not, is revenue going missing?

The fix

Billing is complicated & time-consuming, but you can save enormous amounts of effort by using claim templates customised for your practice. It’s the easiest way to make sure you bill for all consumables & procedures – especially the routine ones that are often missed. Invest in your business by implementing a system that helps you to optimise your claims & boost your revenue as a result.

If you need help to get yourself out of a ‘normalised pain state,’ or you are simply curious to know where your medical practice could be losing money, click here for a complimentary practice assessment.