RCM: Tips & Strategies

3 ways to improve your practice’s financial performance

Payer and market pressures, operational complexity and rising costs make financial viability in community oncology challenging for practice leaders.

Use the tips & strategies below to improve your financial performance and free up time to focus on what really matters — your patients.

1. Increase your revenue

Growing revenue in community oncology is difficult due to increased payer requirements and reduced reimbursement rates. Effectively resolving aged accounts receivable (A/R) and denials can unlock more revenue that you can invest in your practice and people to better serve your patients.

Key Performance Indicators to Track:

120+ Day A/R Aging

Flatiron Best-Practice Benchmark: <5%

  • Prioritize A/R follow up starting with your highest dollar, oldest claims by payer
  • Use average time to payment data to inform first claim follow-up action
  • Address secondary balances aged 60+ days from the primary payment

Denial Rate

Flatiron Best-Practice Benchmark: <5%

  • Consistently touch, classify and appeal every denial you receive
  • Analyze denial trends by location, service and specialty on a weekly and monthly basis
  • Bring trends and analyses to payer representatives to address recurring issues

2. Accelerate your cash

Getting paid quickly is essential to running a viable community practice. Taking longer to collect may prevent you from paying drug bills on time and maintaining positive margins. Keeping your A/R days low and proactively addressing underpayments enables you to get cash in the door faster.

Key Performance Indicators to Track:

A/R Days

Flatiron Best-Practice Benchmark:
25–28 days

  • Create and review your highest A/R agings buckets on a weekly basis
  • Tackle targeted aged A/R recovery projects by payer to collect outstanding cash
  • Optimize business and clinical processes to reduce bill lag and submit claims faster

Underpayments

Flatiron Best-Practice Benchmark:
99.5% Payment Accuracy

  • Reconcile every payment with the explanation of benefits and payer contract
  • Leverage monthly contract allowables analytics to identify and report underpayments to payers
  • Proactively collect patient balances at the point of service to reduce follow-up work and connect patients to assistance

3. Reduce your costs

As drug prices increase and margins shrink, it is important to identify cost reduction opportunities at your practice. Driving staff engagement can drive better clinical and business performance outcomes. While optimizing your drug and vendor contracts enables you to manage your biggest practices expense.

Costs to Track:

Staffing

  • Align your staff incentives to motivate your teams
  • Implement productivity goals and tracking to optimize outputs
  • Compare your staffing models with similar practices in your network

Non-Labor Costs

  • Reconcile drugs purchased, dispensed, administered vs. billed and reimbursed to improve your drug inventory management
  • Move to just in time inventory management for drugs and supplies
  • Review your vendor contract terms annually and renegotiate

By partnering with Flatiron RCM, on average our practices see:

12% increase in year over year revenue

43% reduction in days in A/R

<5% of A/R aged 120+ days

70% reduction in bill lag

Learn more about partnering with Flatiron RCM

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