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January 25, 2021 - Removing Interferences to Your Revenue by Brandy Brimhall


January 25, 2021 Puzzle Piece

Removing Interferences to Your Revenue by Brandy Brimhall

As doctor’s and CA's, we communicate to our patients how interferences in their nervous system are often a cause or contributor to physical signs, symptoms, or more problematic and severe conditions.  We educate our patients that, if these interferences are untreated and unmonitored, the effects can become more severe, take more time and treatment to improve or repair, and can even be the source for new signs, symptoms and conditions that didn’t exist before.
However, with routine evaluation and appropriate care, these signs and symptoms are minimized or eliminated, and more challenging conditions are improved or sufficiently managed –which allows the patient to function more optimally and free of, or with minimal nervous system interferences. 
I believe that the outstanding care chiropractic practices render to their patients makes up the “heartbeat” of the practice, if you will.  Without patients, there is no practice.  To use a similar analogy - in my view, the revenue cycle system (RCS) is essentially the “nervous system” to the practice.  In other words, interferences in the revenue cycle system are the result of numerous signs, symptoms and conditions related to practice cash flow, collections, and even time management.  Here are just a few:

  • Rejected or denied claims
  • Over-the-counter collection uncertainties
  • Inability to properly communicate with patients regarding financial responsibilities
  • Aging accounts receivable balances - including patient and insurance balances
  • Stifled cash flow and collections
  • Practice workforce uncertainties and frustrations
  • Loss of valuable provider or CA time tending to revenue cycle challenges
  • Audit and compliance related vulnerabilities
As with the body and nervous system, the revenue cycle system has many possible causes-and-effects of interferences. These interferences can be in many areas and regions in the collection and revenue system.  Likewise, each area of the revenue cycle system is closely connected to all the others.  This guarantees other interferences occurring, particularly if the system is neglected or improperly constructed or maintained.  In evaluating hundreds of practices, I have yet to find one problem free.
Sufficiently understanding the many parts to your RCS and periodically evaluating each of them, serves as a great diagnostic tool for your practice.  On a broad scope, let’s take a look at a few of the most common revenue cycle system interferences and reasons for these interferences that practices encounter:
Interference 1:  A single gatekeeper
  • If you only have one person who knows what to do, when tasks should be done and how to accomplish them it can be a problem.  This scenario creates immeasurable vulnerabilities to providers because they are extending a blind trust in the financial health of their entire practice - even those with a superstar CA at the helm of these processes.  When that CA moves on or takes time off, the many keys to the revenue cycle system go with them.  Have cross training and backup knowledge for each position.
Interference 2:  Passing the baton
  • It takes weeks and sometimes several months to really learn and become comfortable with some job duties.  The many parts of the RCS are certainly no exception.  Adding an additional team member or replacing an existing team member generally relies on too brief person-to-person training, which results in:  misunderstandings, confusion, essential skipped components, limited-to-no checks and balances, with elements slipping through the cracks.  In many cases where adequate understanding and training is critical, the baton simply does not adequately get passed on, or is simply dropped.  Most of the time without anyone even realizing it until incoming collections and cash flow are restricted or stopped, leaving the practice to worry about what happened, when and how. 
Interference 3:   Insufficient or absent training
  • Many CAs find that they must create their own systems and procedures, often without the tools and resources that would be necessary to give them certainty and confidence in their job.  Sometimes those in charge of billing and collections did not even realize that was going to be their role when they were hired.  They have limited to no understanding of coding requirements, what’s necessary for clean claims and submission, how payor policies and network requirements apply, the necessity of state law knowledge for both insurance and self-pay patients, and the list goes on.  Often when asking why something is done a certain way, I am told, “we just do it this way because that’s what we’ve always done”. 
In this scenario, CAs often feel a lack of confidence in their own performance, and perhaps even know there are missing pieces, but have no-where to go with questions and concerns.  The result:  billing-and-collection errors, uncertainty in what/how to communicate with patients about finances, loss of practice money and time.  This causes costly errors and increased staff turnover. 
Interference 4:  Lack of understanding of the many parts to the revenue cycle system (RCS)
  • The revenue cycle system is quite complex – far more than simply just billing and collecting.  Consider the following components:  insurance verifications, electronic and paper claims, federal payors, Personal Injury and Work Comp payors, patient financial communications, over-the-counter collections, rejection management, claims processing and posting, in-/out-of-network guidelines, patient invoicing, non-covered or alternative treatment procedures, correct coding, claims review and posting, self-pay patients, appeals, follow-up and aged receivable management, etc. 
  • This is a limited list of RCS components.  Not doing at least all these steps brings loss of revenue and practice harmony.  It is very easy to get stuck in the daily mechanics of data entry and billing while many of the crucial components to the revenue cycle system are set to the side, forgotten about, or never even known, much less fully understood!
Interference 5:  Time management challenges
  • There are many hats most CAs in a practice wear on a day-to-day basis.  Even the most talented CAs can find themselves constantly playing catch-up and with a growing to-do list that there never seems time for.  In this scenario, it is often those revenue cycle -related tasks that may be more time consuming that are set to the side and left unattended (subluxated), which costs you serious dollars lost. 
Interference 6:  Insufficient billing, collections, and accounts receivable systems
  • Unattended or poorly attended systems will result in a growing restriction of cash flow.  The older the balance (from patients and payors), the more difficult it becomes to collect and the more costly it becomes to the practice.  Motion is a sign of life – water, air, blood, and even cash flows.  Stagnant monies in billing, collections and accounts receivable systems have many detrimental long-term affects to a practice. These interferences minimize growth, expansion, workforce confidence, efficiency, patient relationships, practice overall value, financial health, and balance if your life and practice. 
In my office, I work with practices every day to help identify and remove those RCS interferences.  In some cases, practices are aware of where interferences are occurring, and some don’t even know.  My job is to give assistance in diagnosis, correction and how to monitor progress or the lack of it.    In many practices, we must identify unknown interferences that may have been restricting cash flow for months or years.  In most practices, these interferences are   in more than one area and sometimes in most areas.  The good news is that improvement and correction are possible for every practice. The great news is that by properly evaluating and implementing a corrective action plan for your revenue cycle system, the stifled cash flow, compliance vulnerabilities, time-management challenges, and other symptoms or conditions your practice is experiencing will either diminish or disappear completely.  Additionally, moving forward, your practice will be able to identify new interferences more quickly as they occur and be better prepared to address them promptly with confidence.
Consider your own practice RCS interferences, as well as the related symptoms and conditions you may be experiencing as a result.  Now is always the best time to take a proactive approach to evaluate and remove Interferences and Subluxations, freeing your practice of those chokeholds that are costing you time, confidence, and money.
Call Brandy Brimhall at 719-349-0220 and or email at [email protected].  Identifying and correcting these interferences is what I do.  Dr John says, what is worse, I really enjoy it…
Live Subluxation FREE,
Brandy Brimhall CPC, CCCPC, CMCO, CPCO, CPMA
  Yours in Health and Wellness,
John W Brimhall, DC, BA, BS, FIAMA, DIBAK


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