Show Me the Money

Can Shannon stay on top of her practice’s revenue stream and help her patients to manage their health care costs without accurate and customizable reports?

Shannon walked out of a treatment room whistling, feeling great about the session. Her patient, Ryan, had come a very long way since the car accident and was actually going to return to work the following week. But she stopped cold when she saw Teresa sitting at her desk with her head in her hands.

“What’s wrong, Teresa?” asked Shannon with concern.

“I know that I’m pretty good with numbers but some days I can’t make heads or tails of where our finances stand!” Teresa said bitterly.

“Tell me what happened and let’s see if we can talk this out,” encouraged Shannon.

Teresa explained how frustrated she was with the insurance reimbursement process. Since they were still generating reports by hand, she never felt as though she had control of financial matters. Some insurance claims were dragging out for months and, without being sure of when reimbursements might come, she was having difficulty budgeting ““ or at least budgeting confidently ““ for other office expenses.

“I was positive that the claims for Christine Jackson and that handsome young teacher, John Santos, would have come through by now, so I went ahead and began the process of purchasing a new copy machine,” explained Teresa. “You know how frustrated Tana gets when she has to copy care instructions for new patients. But the claims haven’t come through and we’ve got other major expenses coming down the pike. I just don’t feel like I’ve got a handle on our finances at all.”

Shannon was quite troubled to hear this. The practice was in good financial shape but she had never imagined that tracking insurance reimbursements might cause such trouble for Teresa, who worked so hard to keep the practice’s financial status pinpointed precisely.

“Well, don’t we know by now how long each insurance company’s accounts receivable window is?” questioned Shannon.

“It’s just not that simple!” said Teresa, exasperated. “We accept more than 20 different types of insurance, and each of those companies has plans with various levels of coverage. Plus, you know that some companies are just a lot less helpful than others, so even the smallest error in the treatment code or a line left blank can hold the process back for weeks!”

Shannon thought about that for a minute. It really was unfair to expect Teresa to track all of these things manually. She knew that her friend Arian’s practice used a dashboard that helped track everything from changes in personal information to each family’s billing and payment status.

“The worst thing is that some of our patients are really struggling to pay their bills but, by the time they really understand what their care plan might cost, it’s almost too late for us to even try and help work things out for them,” Teresa finished.

The two looked at each other uncomfortably, Shannon’s satisfaction in her recent physical therapy session forgotten. She wished she could simply focus on what she loved to do ““ to help people feel better ““ instead of worrying about administrative issues. And she hated to see Teresa so upset.

Might there be a solution to the insurance reimbursement issue at Shannon’s practice?

Disclaimer: For HIPAA compliance, all characters appearing in this post are fictitious. Any resemblance to actual persons or actual events is purely coincidental.