Payer Allowed Amounts: Part 3

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We generally see differences much bigger than this with practices that we work with. That's why it's so important that whatever system you are using, is able to automatically figure out these three numbers and to automatically provide these stats by payer, by clinician, and by procedure. The system you use should automatically kick a claim back to whoever is responsible on your staff. Or if it's third party, if you have us helping you with that for example, the claim goes back to the team so that they can chase this down for you. Super, super important!! This approach...that's how you maximize return on investment. Again, this is something that your billing team should already be doing. An approach like this should not cost anything extra. If it's automated in your software, your team should already be expected to do it.

The problem that you're having is it's a gap, and so, the maximum return on investment here is actually just implementing something that should already be in place. A really helpful tip, as you are putting this into place, is to keep track of the amount that you're getting in your return on investment. Please send that back to us. Let us know what you're seeing if you're not clients of ours. If you are clients of ours, we know. But if you're not clients of ours, put this into action and let us know, "Hey, are you seeing problems with allowed amounts? If you are, on average, what's the amount underpaid?" Then of course, how much do you stand to make or how much are you starting to make now that you've implemented this approach?

As an owner, be very careful about looking at billed versus collected as the be-all-end-all stat for revenue, for A/R, whether it's insurance or cash. It's always, always going to be a little more complicated than that. That's why this 4 Q&A process is so helpful, right? Once you really understand what the problem is, understand why it's so important, why it's so difficult to solve and why it's not so simple, you are ready to start thinking of viable solutions. Come up with at least two or three ways to approach solving that problem so that when you go in to solve it, you have more than one way to maximize your return on investment. It is well worth the time. We promise. Over the next 10 years, you're talking about hundreds of thousands of dollars, sometimes, millions of dollars in recovered revenue, that you wouldn't have gotten otherwise.

Alright! We wish you the best of luck! To your success and we'll see soon!