What Best-in-Class Billing Insights Look Like for Private Practice

What Best-in-Class Billing Insights Look Like for Private Practice

Hersh Solanki, Chief of Staff
Hersh Solanki, Chief of Staff
August 1, 2022

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It’s never been harder to run a profitable medical practice. Reductions in Medicare pay, staffing shortages, and bloated administrative work mean you have to change to survive. Here are questions that you should know the answer to:

  • Which of your providers saw an abnormally low amount of patients this past week?
  • Which insurances have the highest denial rates?
  • What are your most common denial reasons?
  • How much money did your practice receive yesterday?

At Athelas, we answer these questions so you don’t have to. We turn every healthcare practice into a world class business. How?

Athelas Insights is our proprietary, state of the art analytics tool that allows providers to understand the health of their practice in 30 seconds or less. You have direct insights and recommendations into how to generate more revenue. Ultimately, it reduces the stress of running a practice by bringing clarity and offering easily digestible, actionable advice. Below are a few key features of Insights.

Payments Insights

Understanding monthly trends are key to ensure cash flow consistency. Visualizing daily payments and cashflow fluctuations allows you to plan for operational expenses and ensure your business is running profitability.

Provider Insights

Patient flow is a key leading predictor of revenue. Understanding your practice’s flow of patients is essential to understanding its growth trajectory. Seeing follow ups vs new patients allows you to shift the mix to hit your own targets. It’s a positive sign to see certain providers seeing more patients compared to their historical average! This module is also highly customizable, allowing you to see your patient flow on a weekly, monthly, or annual basis.

Overall Practice Insights

Insights doesn’t just provide numbers. It goes one step further to provide actionable analytics. For the above practice, we see that BCBS is a fantastic insurer, while Medicare California North is getting denied at a higher than expected rate. These analytics allow you to understand why you may not be getting paid as much as you expect.

Denial Analysis

Why are your claims getting denied by insurance? Are you coding improperly? Do you need additional insurance contracts? The Insights real-time denial analysis helps you understand the reasoning behind your denials. For the above practice, a quick search uncovers eligibility is the largest reason for denials from Aetna - with close to $4,000 in claims rejected in the past year. We can therefore deduce that the above practice’s biller wasn’t conducting Eligibility checks before all scheduled appointments, despite eligibility being a key component of the revenue cycle.

These are a few of the many Insights that would be available at your fingertips with Athelas RCM. Working with Insurance can be a one sided affair, the only way to stay ahead of the game is to work with experts who have more data than they do.

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Join us for a tour of the Athelas RPM devices Thursday at 10am Pacific, followed by Q&A. We'll cover how RPM data impacts clinical decision making, applicable CPT codes, effects on patient engagement, and much more.

Intro to Remote Patient Monitoring