Revenue cycle indicators for the faculty practice in the month of February and year to date (YTD) were almost universally strong, according to chief revenue cycle officer Tom Chacko. Both gross charges and wRVUs were up significantly over the same time period a year ago–up 14.6 percent in gross charges and 8.5 percent for wRVUs. Gross revenues also increased by 10.9 percent for through YTD February 2016.
A number of other key operating indicators (KOIs) improved as well compared to the prior fiscal year. Total write-offs (a figure that does not include bad debt) are down 18.5 percent. Days in AR are lower by 2.8 percent (currently 45 days), and AR greater than 180 days is at 9.5 percent, improvement of 11.7 percent. The Faculty Practice Solutions Center industry median for percentage of AR greater than 180 days is 8.7 percent. Year-to-date total credit balances are down by 8.1 percent.
All of these KOIs look even better when International accounts are excluded, Chacko said. International AR takes a long time to adjudicate, especially payers from Middle Eastern embassies. Self-paying patients are a challenge when their length of stay exceeds initial estimates.
Challenges with domestic payers include the following:
- CMS has taken more than eight months to process a Tax ID change and a new Medicare group application for Orthopedic Surgery, which has resulted in significant delays with claim submission. Additionally, there were ramp-up delays with the new spine program.
- One major payer has been operating with two-to-three-month delays in enrollment loading, while their Managed Medicare plan has flagged anesthesia claims for a full audit, resulting in payment delays.
- Health Republic is now out of business. We are awaiting adjudication from the Department of Financial Services with regards to our open AR of $3.4 million.
- Delays with reviews of medical notes are an issue for another major payer.