TUNGKOL SA EPISODE NA ITO
What if your practice isn't losing revenue because your team is failing but because the payer's system is simply better organized?
In this episode of The Snapscale Show, Nathan Bush sits down with Ryan Cooper, founder of Plural Consulting, to unpack the hidden challenges behind revenue cycle management and what he calls “revenue defense.”
Ryan brings a unique perspective to the conversation. After spending 16 years in healthcare, operating multiple healthcare entities, managing clinical and administrative teams, handling billing, credentialing, enrollment, prior authorizations, and implementing EMR systems, he experienced firsthand what happens when revenue gets held up and how it can threaten an otherwise well-run healthcare organization.
About Snapscale
At Snapscale, we help healthcare practices scale their operations with HIPAA-compliant virtual assistants trained specifically for healthcare workflows.
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In this episode, you'll learn:
- Why practice owners need to think beyond traditional RCM
- How payer processes can impact your practice's cash flow
- Why clinical and administrative teams need to work together
- What questions practice owners should ask their billing teams
- How RCM partners should communicate and measure performance
- How technology, AI, and specialized teams can strengthen revenue operations
If you're a healthcare practice owner wondering where your revenue is going and how much you're leaving on the table, this conversation is worth watching.
Connect with Ryan Cooper: https://www.linkedin.com/in/ryan-cooper-75b420152/
Chapters:
00:00 – Introduction
05:30 – When Getting Paid Becomes the Biggest Risk
09:30 – Stop Siloing Clinical & Administrative Operations
15:30 – Build Your Own Revenue Defense System
21:30 – The Metrics Every Practice Owner Should Know
27:00 – You Already Worked for That Revenue
#RevenueCycleManagement #HealthcareBusiness #PracticeGrowth
IPAKITA ANG TANDAAN 🔗
KOPYA NG SALIN 🔗
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And he's been the CEO who stayed up at night wondering where the money went.
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Now he runs plural consulting and he helps practices solve that exact same problem he's serving your patients well, but making sure that you're getting paid and you're able to keep the lights on and you're able to grow.
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Welcome to the Snap Scale Show, the podcast for healthcare leaders who want to grow their practice without the burnout, the chaos, or the staffing overload.
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Every episode, we sit down with the people figuring out how to build stronger teams, better patient experiences, and ultimately better care.
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Let's get into it.
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All right, guys, let's build something.
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First up, I'd like to introduce Ryan Cooper.
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Ryan Cooper is incredible.
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Most people who speak on stages like this, they learn what they know from outside of healthcare.
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Ryan Cooper learned it from the inside, the hard way.
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He actually operated healthcare facilities and ran a mental health-intensive outpatient program.
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He recruited and managed physicians, nurses, uh, nurse practitioners, sleep techs, lobotomists, and he's been the CEO who stayed up at night wondering where the money went.
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Now he runs plural consulting and he helps practices solve that exact same problem he once lived through.
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His session today is on revenue cycle mastery and eliminating what he calls administrative blow.
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And I promise you, by the end of this 25 minutes, you'll be looking at your billing department just a little bit differently.
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I'd like to welcome to the stage Ryan Cooper.
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What's up, Ryan?
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How are you?
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Hey Nathan, doing great.
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How are you, sir?
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Yeah, super excited to have you here on the Advanced Practice Forum.
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Uh, we're gonna be talking a little bit about revenue cycle management.
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I'm gonna go ahead and uh bring up your slides and then give you the floor here, man.
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Sounds good.
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Thank you, Nathan, and uh thank you to you and Snap Scale for allowing me to talk here.
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I appreciate uh all the work you you all do in healthcare.
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You help a lot of practices, and uh, there's a lot of problems to solve.
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And I'm gonna go into some of those problems right here and right now.
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And so um Nathan already introduced me, so I don't need to necessarily do that, but today I'm I am gonna be talking about revenue cycle mastery and eliminating administrative bloats.
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And more specifically, what I'm gonna be talking about is something I call revenue defense.
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Revenue defense is how I look at revenue cycle management and healthcare operations.
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And that's what the lens, that's that's the lens that I actually look through.
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So let me go through really quick and uh with with who I am and get that uh get that going.
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So I didn't, as Nathan mentioned, I didn't come into revenue cycle management through the billing office.
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I've been in healthcare roughly 16 years.
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Um over that time I worked on the clinical side and in sleep medicine.
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And I uh at one point I was managing four different healthcare entities simultaneously.
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It was an outpatient practice, an IOP mental health facility, a high-complexity clinical laboratory, and a sleep center.
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So I've worked with multiple different types of operations, multiple different types of revenue cycles, and they all have their intricate challenges.
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Um, in addition to that, I've done the billing myself, credentialing enrollment myself, made the prior off calls, countless prior off calls, countless treatment plans.
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Uh so I've I've seen the ins and outs.
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I've had a weird and winding road in this industry, and it just so happened to give me a lot of insights to be able to help practices uh with that revenue defense.
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And so in addition, I've implemented EMR systems with all the bells and whistles, the CPT codes, the clinical templates, workflows, all of that.
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I've undergone joint commission surveys, CARF surveys, clinical laboratory improvement surveys, and a Medicare site survey, which was fun.
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Then, as Nathan had mentioned, I was CEO and part founder of a healthcare facility.
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And as the healthcare facility, we achieved 1437 quality standards with our accreditation, and we also achieved a 95% patient satisfaction.
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We had our operations down to a science, the trains ran on time, and I still lost the facility.
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Now I'll come back to that in just a minute, and that's why I'm gonna give things to you through a little bit different lens here.
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I'm not here to give you theory, I'm here to give you real life because that's what I lived.
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And so, first of all, I'm gonna be saying some things about payers that are that are generally unsavory because that's just the reality.
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Um, but first, a caveat: I'm not here to attack anyone that works for a health insurance payer.
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I've met many of these people, a lot of good people that work for these payers, been on countless prior authorization calls.
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A lot of them just want to help patients get care.
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Um, you know, even talked to a retired health care insurance CEO at one point who who uh was a really nice gentleman, really good man.
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And, you know, even he said, look, this is just a big system, the machine's running.
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You know, once you get to a certain point, there's not much you can do.
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So, you know, I'm here to talk about the system that works against practices, not the people.
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Um, because the system's developed oftentimes by people who no longer work there anymore.
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So uh let me let me explain to you really quick what happened.
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Um, as I mentioned with my facility, we got it credited, we did the credentialing, the enrollment, we were even accepted into the payer networks, and then they held out revenue.
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Claims were coming back.
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They said, well, we have no idea why.
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Call after call took over, it took months, but it really took over a year to get some resolution on it.
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Call after call after call.
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But by that time it was too late.
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We had already pumped capital in, keep our staff paid, keep keep everything running, keep the lights on.
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And eventually I had to close the doors.
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And then after that time, I spent a lot of time trying to figure out what went wrong.
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I spent that time actually learning their playbook, learning their tactics, learning how they hold your revenue and how they actually use that hold to turn a profit in the form of float.
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Warren Buffett will tell you about that if you want to ask him.
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So I actually researched over this time, not just the payers, but over 3,000 RCM companies.
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I'm not kidding, I can show you the list.
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And I talked to well over 100 of them.
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I have a lot of friends in the revenue cycle management industry.
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So, what I do now is I help healthcare practices and facilities get paid for the work they do.
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And I make sure that what happened to me is not going to happen to anyone who works with me.
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Period.
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That's where my team and I we set up revenue defense systems.
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And I'll explain a little bit more about what that means here.
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But first, what did I learn about these health insurance payers?
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First thing I learned is that I was outmatched, and right now, if you don't have good revenue defense set up in your practice, you are outmatched.
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It's just the reality.
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Most practice owners don't even know what battle they're actually fighting.
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I didn't.
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They don't know who their real competition is.
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It's not other practices, it's the payer.
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The payer is the one that is putting you out of business.
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Not not there's plenty of patience uh to go around.
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It's not there's that's never a problem.
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So a lot of practice owners think that I'm offering good care, I'm taking care of my patients, I have good operations, um, paying my staff well, that should be enough.
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And it should.
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And I wish it wasn't this way, but it's just not enough.
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And uh that's just the the nature of it.
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And so, you know, here is how everyone, I don't want to say how everyone else sees insurance companies, but here's what the here's here's what the payers sell you.
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The payers promise.
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Look at that lovely smiling family.
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You pay your premium, you get care, and then they pay the claims, they make sure your doctor gets paid, and they're there to help you every step of the way.
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What's funny is you know, none of us really believe this.
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Everyone really knows what what's going on here, but this is the rosy view they sell you.
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And ever since I actually looked behind the veil of what the payer tactics and strategies are that keep practices from getting paid, here's how I see insurance companies.
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The payer denial infrastructure.
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They have claims editing, off protocols, coding hurdles, post-payment audits, recruitment teams, and AI agents working around the clock.
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Organized, fully funded, locked and loaded, pointed at your revenue.
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That's it right there.
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They have an army of resources to hold your revenue so that they can actually claim interest on that revenue, and then they'll eventually throw you a few bucks once they turn their profits over.
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And most practices, here's what they're working with: they have an EHR practice management system, they work through a payer portal, which is actually designed for the payers, not for the practice.
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And oftentimes they may have a biller, maybe a couple billers, maybe a billing team, or maybe you know, a vendor that may or may not be doing what needs to be done or may not have the resources.
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And there's a lot of great vendors out there, and I definitely don't want to rag on any of them.
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Um, but I've seen the good ones and I've seen the bad ones.
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So, what can you do if if you're you're you're you have a slingshot and you're facing an entire army?
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Well, question to ask is where do you stand against the payer?
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Where do you stand?
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What resources do you have?
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What are you working with?
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Where do you stand against yourself?
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What what what do you have going on in your operations that is not only serving your patients well, but making sure that you're getting paid and you're able to keep the lights on and you're able to grow.
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And then the final question is how do you stand against both?
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You have to you have to deliver your patient care, your operations, and then you have to make sure you get paid.
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It's two sides of the coin.
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So, first thing to do is start by protecting your home base, and to do that, you have to get everyone on your team and your practice in your facility roaming in the same direction, no exceptions.
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And the way to do that at a high level is you have to integrate your clinical and administration.
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Now, again, I've worked in healthcare a long time, and I've seen a lot of organizations and worked in one even where you had the administration over here, you had the clinical over here, and there was just they weren't talking to each other the way they needed to.
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I've seen uh clinicians, you know, a lot of times what I see is clinicians that, and I'm not ragging on clinicians, clinicians are are who serve the patients to make their lives better.
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But you have, you know, I've I've seen clinicians where I don't want to get involved in administration, just you know, let me just see the patients and let them deal with it.
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And the administrative is I don't want to get into the clinical.
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But when I was running my facility, the way we had operations tight, first of all, we ran on the EOS model, which is uh something I recommend.
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I'll give them a free plug if you want to look them up.
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But I would have a meeting every week.
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We'd have our continuous cycle of improvement meeting every single week, where I'd have myself, my clinical director, my marketing director, and my admin staff.
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And we would all bring problems together that we saw that we could solve together.
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My clinicians knew what was going on in marketing.
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The marketing was educated by the clinicians on what was going on with the patients, and the administration was integrated into both.
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In fact, my marketing director would take notes from my clinical director on the best marketing strategies because they know the patient better than anyone else.
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You have to integrate, that's the only way to protect your home base.
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You cannot silo, and that's where the administrative bloat gets trimmed out is everyone's job is easier and everything flows well because everyone's working toward the same goal.
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And then the centerpiece of that needs to be your revenue cycle.
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Everyone needs to understand, yes, we're serving patients over here.
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Yes, we have operational processes that need to happen over here, but they need to work together and know that, hey, guess what?
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We're running a business here, and the only way that the lights are going to stay on, the only way that everyone's gonna get paid, the only way that we're gonna grow and be able to serve more patients and serve them better is through working together, integrating it into one singular direction.
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And through that, not only does your revenue cycle improve, your patient care improves, your administration improves, your marketing improves, everyone's happy doing their job, everyone knows everyone else's job, and life is just easier.
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So that's protecting the home base, which is just vital.
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You have to start there.
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Once you protect the home base, then you have to fight and turn your fight outward to the payer infrastructure.
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Now, most practices, I already illustrated that, are not playing on a level playing field.
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They're using a slingshot against an army.
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It's just the way it is.
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So you have to find ways to level the playing field.
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You need to develop a playbook that is the exact inverse of the playbook they're using.
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You need more resources, you need more tools, you need more weapons, you need better strategies.
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But again, the home base first, then you turn the fight outward.
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And then your strategy needs to constantly be improving and evolving because theirs are.
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It used to be where they'd have somebody offshore denying your claims, now they just have machines, machine learning denying your claims.
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So you have to level the playing field.
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So one way, and and there are multiple different ways, and this is why I I applaud SnapScale because they actually have ways to do that as well.
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They they can actually put people in your practice that can help that infrastructure, not only help the home-based infrastructure and bring it all together, but also help different aspects of your revenue cycle.
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And this is this is the inverse model that we use, a plural that my team uses.
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So you remember the first illustration where I showed you the payer denial machine.
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This is what our infrastructure looks like and what my team's infrastructure looks like.
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So what we have is Lean Six Sigma sort of uh excuse me, center of excellence teams, and they are organized in tiers.
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Again, to be a direct inverse of the payer playbook.
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That's why when I say I have my own playbook, we've got it.
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So this is organized first tier by payer.
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We at we we fight the payers with one single one team fighting the payers.
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Each payer gets their own gets their own battlefront.
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Under that, our teams are organized by function.
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That would be, of course, patient registration, eligibility, prior auth, charge capture, denial management, and everything in between.
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Even well, of course, credentialing enrollments.
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And then in addition to that, we have EHR vendor specialists for whichever EHR our clients happen to be working with.
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So, and again, this is this is something I want to illustrate.
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A lot of RCM partners actually do this.
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Again, Snap Scale, they have the ability to to uh integrate into multiple areas of your practice.
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Ours, we have multiple teams that are tiered to be able to fight that battle for you and partner with your practice.
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Now, once you establish good revenue defense in your practice, this is this is generally what can happen.
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This is the this is the outcome, and these are the outcomes that we've seen.
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This is most recently.
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Here's what happens when you secure your home base and you establish the resources you need and use them.
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Here's an Indiana facility.
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They came to us with one and a half million in AR.
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They were doing a lot of things right, just like I was, and they were suffering just like I was.
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And once we were able to get them onboarded, which we did in one week, most RCM companies take about six to eight weeks.
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We onboarded them one week because they needed immediate triage.
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And we were able to increase their revenue in 30 days.
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So we onboarded them one week.
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After that, one week, we started billing and collecting on day one, and within 30 days, we increased the revenue 116 percent,$200,000 a month to$432,000 a month by implementing that multi-tiered team system.
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Maryland practice$220,000 a month to$550,000 a month in six months' time.
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$150 revenue increase, 30% patient collection increase.
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That's a big part of it.
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That's a big piece that uh a lot of practices struggle with, or is that patient collection piece?
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But once you implement the right team, the right strategies, take care of your revenue cycle from the very beginning, that makes the endpoint a whole lot easier.
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Louisiana Practice started about$90,000 a month.
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Their revenue increase went up to$130,000, 44% in four months.
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Their patient collections are able to increase 125%.
00:18:53.279 --> 00:18:56.079
Now, let me back up for a second, too.
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This is not this this money just doesn't come from nowhere.
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This isn't money we're adding to their practice, this is money they already worked for.
00:19:05.599 --> 00:19:13.599
That's what's so frustrating with a lot of the practice owners and doctors I've talked to over the years, and I even talked to now because it isn't getting better, it's getting worse.
00:19:13.839 --> 00:19:15.920
This is money they already worked for.
00:19:16.319 --> 00:19:18.799
They've done the hard work for their patients.
00:19:19.119 --> 00:19:26.640
They they they you know, if you've worked in a medical practice or if you own a medical practice, it's hard work.
00:19:27.200 --> 00:19:30.000
And and and I respect anybody who does that work.
00:19:30.160 --> 00:19:33.920
I did it, I worked with those who did it, and it's hard.
00:19:34.160 --> 00:19:43.440
And you do all this work and you you serve your patients well, you're trying to improve people's lives, and then you you you look at your numbers, you know.
00:19:43.519 --> 00:19:48.400
As a practice owner, you you you you you have those Sunday night through 3 a.m.
00:19:48.720 --> 00:19:58.240
I mean, this is this is my experience, you know, Sunday night, you're up at 3 a.m., you're looking at your numbers, and you're trying to figure out how you're gonna make payroll the following week.
00:19:59.359 --> 00:20:01.680
That's that's no way to live.
00:20:02.079 --> 00:20:04.319
But there are practice owners right now suffering.
00:20:04.640 --> 00:20:14.720
I know that there are roughly 5,000 mental health facilities right now in immediate distress with their revenue cycle.
00:20:14.880 --> 00:20:15.920
That's just in mental health.
00:20:16.000 --> 00:20:18.000
That's one corner of healthcare.
00:20:18.400 --> 00:20:21.279
If you look at all of it, it's probably staggering.
00:20:22.079 --> 00:20:33.359
And and the fact that these people are there to serve other people and suffer so much is just it's unacceptable, but it can be fixed.
00:20:35.039 --> 00:20:38.799
So we'll go into revenue defense results.
00:20:38.880 --> 00:20:52.640
This is what this is this is these are the results you can see, and and and one one of the things I would think about in your own practice is what revenue are you earning that you're not getting?
00:20:53.359 --> 00:21:01.279
If if these practices here were able to we're we're missing 116% of their revenue, how much are you missing?
00:21:02.480 --> 00:21:04.000
Where's it where's it going?
00:21:04.319 --> 00:21:05.279
Why don't you have it?
00:21:05.359 --> 00:21:06.960
Why isn't in your bank account?
00:21:09.680 --> 00:21:22.319
So, one of the other things I want to show you is when you are working on your revenue cycle, now again, I understand that some people have internal billers, some people have RCM vendors.
00:21:22.880 --> 00:21:38.160
Uh, but one thing you want to think about and think about seriously is this RCM vendors are companies that are on the periphery of your operations.
00:21:39.440 --> 00:21:58.720
But what you want is an RCM partner, and that's what companies like Plural, Snapscale, good companies like that work as a partner in your practice, they integrate with your operations, they know your practice operations inside and out, and that's that's that's exactly what you need.
00:21:58.960 --> 00:22:05.759
So and And from myself, my own experience, I've been in the practice owner's shoes and lived out their worst fears already.
00:22:06.559 --> 00:22:19.119
So that's why I come at this not from a billing vendor standpoint, but I've worked in the practice and a lot of times just from my own experience, not because I'm special, but I've just had this long and winding road in healthcare.
00:22:19.359 --> 00:22:33.279
Once I usually talk to a client, I generally know their operations a little bit better than they do, just because I've seen it and I know what to look for ahead of the curve of what's happening with their revenue cycle and what to expect from the payers.
00:22:33.759 --> 00:22:40.720
One of the things you're going to want with your RCM vendor or partner is going to be rapid response times.
00:22:41.039 --> 00:22:43.599
Communications multiple times per week.
00:22:43.920 --> 00:22:51.359
You know, a client we recently uh took on, they they they would wait two weeks to hear from their billing partner or their billing vendor.
00:22:51.519 --> 00:22:52.400
Two weeks.
00:22:52.640 --> 00:22:53.680
You know what can happen?
00:22:53.759 --> 00:22:59.680
You know how much can be billed out and how much revenue you could you're billing out in two weeks that you could lose.
00:22:59.839 --> 00:23:01.200
You know how many things could happen?
00:23:01.359 --> 00:23:04.640
You know how much AR could expire by then.
00:23:05.119 --> 00:23:06.079
And it did.
00:23:07.599 --> 00:23:09.359
And you want rapid response times.
00:23:09.599 --> 00:23:14.559
You want if you're if you're if your biller is not emailing you a couple times a week, that's a problem.
00:23:15.039 --> 00:23:20.160
Our clients oftentimes have our bill have our teams emailing them every day.
00:23:22.160 --> 00:23:24.480
Weekly KPI review calls.
00:23:24.720 --> 00:23:29.119
This is something I did not experience when I was in healthcare administration.
00:23:29.359 --> 00:23:37.359
A lot of times a billing vendor would send us uh they'd send us the total collections for the month and an invoice, and that's all we would have.
00:23:40.160 --> 00:23:49.519
But in order to have a partner working with you in your practice that actually feels like a partner and functions like one, these weekly KPI reviews are vital.
00:23:49.759 --> 00:23:52.160
That way you can get on immediately in real time.
00:23:52.319 --> 00:23:58.960
What's working, what isn't working, what uh what denials are we seeing, what uh what coding issues are we seeing?
00:23:59.119 --> 00:24:11.440
Oh, we have a clinician that uh didn't put in a code wrong or they didn't lock their note, or you have new clinicians who need to be credentialed and rolled, and you know, there's an issue, so let's talk about it.
00:24:11.599 --> 00:24:18.319
These weekly KPI reviews are important, monthly strategy calls, these are important too.
00:24:18.480 --> 00:24:23.519
Improvements moving forward, pulling out to 10,000 feet, and also this is where the growth happens.
00:24:23.759 --> 00:24:26.640
I mean, most practices want to grow, you have to.
00:24:26.960 --> 00:24:32.880
Uh if you don't want to grow, then you know, um, but but this is where this is where it all happens right here.
00:24:33.039 --> 00:24:33.920
Monthly strategy calls.
00:24:34.000 --> 00:24:36.079
It's like good, we took care of April.
00:24:36.319 --> 00:24:38.000
How are we gonna work May?
00:24:38.160 --> 00:24:40.559
And what's June and July and August going to look like?
00:24:40.640 --> 00:24:41.440
What do you have coming up?
00:24:41.599 --> 00:24:42.960
Are you gonna hire more clinicians?
00:24:43.039 --> 00:24:44.960
How can we make that work for you?
00:24:46.960 --> 00:24:53.839
And then one that I think is an absolute necessity is they have to put themselves on the line.
00:24:55.839 --> 00:24:57.279
What does that mean?
00:24:57.920 --> 00:25:03.839
Well, listen here, 100% transparency, zero exceptions.
00:25:04.400 --> 00:25:08.079
This is a big problem in medical billing nowadays.
00:25:08.319 --> 00:25:12.079
A lack of transparency, lack of communication, lack of transparency.
00:25:13.119 --> 00:25:19.440
If they're not doing self-audits of their own performance, then I would ask them to do a self-audit of their own performance.
00:25:20.960 --> 00:25:23.119
Otherwise, how do you know what's going on?
00:25:23.359 --> 00:25:28.640
You the the the rule in business is that you can only control what you can measure.
00:25:28.799 --> 00:25:31.519
And if something isn't measured, I would question it.
00:25:34.319 --> 00:25:39.359
So, as I mentioned, securing your home base is absolutely vital.
00:25:39.759 --> 00:25:44.799
Get your operations in place, work on a system, find what system works for you.
00:25:44.880 --> 00:25:46.240
There's plenty of systems.
00:25:46.480 --> 00:25:50.559
You can go as far as Lean Six Sigma if you if you really want to dive deep.
00:25:50.720 --> 00:25:53.359
Uh, EOS is one that I've used and implemented.
00:25:53.440 --> 00:25:55.039
It works very well, it's very simple.
00:25:55.200 --> 00:25:58.000
It'll help you with that continuous cycle of improvement.
00:25:58.480 --> 00:26:01.680
And then what you want to do is you want to turn the fight outward.
00:26:02.240 --> 00:26:13.759
Once you know what's going on in your practice, in your facility, then you can develop the resources to fight the big payer machine that's well trying to hold your hold your revenue.
00:26:14.000 --> 00:26:20.799
So, yeah, that is what I have, and hopefully that gives you something to think about today.
00:26:21.039 --> 00:26:29.440
Um, because this this is something that um it's it's one of the hardest parts of keeping a practice afloat and keeping it thriving.
00:26:33.279 --> 00:26:34.319
Well, thanks, Ryan.
00:26:34.400 --> 00:26:36.880
I appreciate you joining us today.
00:26:37.119 --> 00:26:46.240
Um, I just had a couple of questions that had come up in the comments and uh wanted to make sure that we got those answered as we're going throughout the day today.
00:26:46.319 --> 00:27:00.319
And so uh one of the questions came in is basically for a new practice owner or a practice owner that has no idea whether the building's working or not, what's the first question they should walk in and ask their billing staff on Monday morning?
00:27:01.119 --> 00:27:03.119
What's your denial rate?
00:27:03.599 --> 00:27:05.119
What is your denial rate?
00:27:05.279 --> 00:27:11.519
That is going to be the start, the the very starting question of where the rest of your operations falls.
00:27:11.599 --> 00:27:16.640
Uh, most practices right now are experiencing roughly 15% denial rate, 10 to 15%.
00:27:17.359 --> 00:27:23.200
Your denial rate, starting by asking what is your denial rate, then you start asking why.
00:27:23.359 --> 00:27:25.119
Why are these claims being denied?
00:27:25.279 --> 00:27:37.119
Oh, it's because of you know, at the very beginning, we're the verification, we're not checking, we're not, we don't something's broken in the verification process, or we're having an issue with prior offs, or we're having an issue with coding.
00:27:37.200 --> 00:27:39.759
You look down the line and it'll tell you.
00:27:41.599 --> 00:27:42.640
That's great.
00:27:42.880 --> 00:27:53.119
The next question that I have here um says that if a practice is collecting 90% on every dollar they bill, is that good?
00:27:53.359 --> 00:27:55.440
Or what should that number be?
00:27:56.240 --> 00:28:00.720
Yeah, usually it's going to be you're gonna want a 95% collection rate.
00:28:00.880 --> 00:28:14.480
Um, 100% is fantastic, but we you know, we do live in a reality, but you yeah, nine, I would say 90% isn't terrible, but it's worth it's worth chipping at that that extra you know five, 10% to see what's going on there.
00:28:14.559 --> 00:28:29.039
I mean, really, you know, with anything, but with this in particular, you know, as I mentioned, the payers are the payers are operating with such an intricate system to deny as much as possible.
00:28:29.440 --> 00:28:32.640
I would say be aggressive on your end too.
00:28:32.799 --> 00:28:38.240
If you if you're missing five for if you're missing 10%, if you're missing five percent, go for it.
00:28:38.720 --> 00:28:45.920
You know, use those aggressive strategies, use the resources, find out again back to finding out the what, and then let's go to find out the why.
00:28:46.000 --> 00:28:47.200
Why is this happening?
00:28:47.359 --> 00:28:48.960
Why are we collecting 90%?
00:28:49.839 --> 00:28:58.000
Uh because because it really, if you think about it, Nathan, you're talking about thousands and thousands of healthcare practices across the country.
00:28:58.240 --> 00:29:08.559
If a payer wants to stiff somebody stiff one practice 10%, stiff thousands of practice 10%, then at that point, you know, that's a lot of that's a lot of coins they're picking up.
00:29:09.039 --> 00:29:15.359
Um, so I would say to a practice owner, you know, grab as many of your coins as you can because you already worked for it.
00:29:16.319 --> 00:29:17.599
Yeah, incredible.
00:29:17.759 --> 00:29:25.200
Uh question that I had, I wrote down that I wanted to ask you before we even hopped on this thing after you and I had a number of conversations.
00:29:25.599 --> 00:29:32.640
You know, your organization does a lot to help alleviate overstaffed organizations.
00:29:33.039 --> 00:29:38.559
What's one role in practices that you always see that are overstaffed?
00:29:39.200 --> 00:29:39.839
Yeah.
00:29:40.720 --> 00:29:48.640
Overstaffed is going to be the front, the front office can tend to be a little bit overstaffed at times.
00:29:48.880 --> 00:29:58.000
Um, that's that's generally going to be and look, front office is is is important and and having that face-to-face with your patient is is very important.
00:29:58.720 --> 00:30:11.599
Um, but a lot of times there can be, you know, we implemented workflows um where we didn't really need a big front office, and and the the person actually working the front could focus on being there for the patients.
00:30:11.920 --> 00:30:14.720
And uh, and now you know, the you know this name.
00:30:14.799 --> 00:30:18.079
There's a lot of little administrative processes that just can take up time.
00:30:18.240 --> 00:30:22.319
You know, I I've talked to practices who said, well, how do you how do you track everything?
00:30:22.480 --> 00:30:24.720
It's like, well, we track everything on an Excel sheet.
00:30:24.880 --> 00:30:31.359
It's like, well, that's that's you know, 1999, you know, uh operational strategies.
00:30:31.519 --> 00:30:35.759
Uh there are, and as you know, you can you know you can implement AI systems nowadays.
00:30:35.920 --> 00:30:37.759
There are HIPAA-compliant AI platforms.
00:30:37.920 --> 00:30:48.160
There are uh multiple different things you can do to just streamline and and it's a corporate term, forgive me, streamline those processes and and just make things run a little bit smoothly.
00:30:48.240 --> 00:30:52.960
And and I don't, I'm not necessarily advocating for limiting jobs because Snap Scale doesn't do that.
00:30:53.039 --> 00:30:55.279
You you provide jobs, and I appreciate that.
00:30:55.519 --> 00:31:01.599
Um But you know it's it's having managing people is hard.
00:31:01.920 --> 00:31:08.559
And I guess the the what I would say is if you're managing too many people, uh that's just gonna make it harder on you and harder on them.
00:31:09.039 --> 00:31:10.559
Yeah, yeah, absolutely.
00:31:10.720 --> 00:31:11.440
All right, Ryan.
00:31:11.519 --> 00:31:15.519
Well, any final thoughts as we wrap up here that you want to leave people with?
00:31:15.680 --> 00:31:20.960
How can people get in contact with you if they had more uh questions about your service and what you do?
00:31:21.279 --> 00:31:21.839
Yeah, yeah.
00:31:21.920 --> 00:31:26.000
If you have any questions, um you can go to my LinkedIn at Ryan Cooper.
00:31:26.079 --> 00:31:38.640
Uh that's uh you you can reach that's that's generally where you're gonna find a lot of my uh my content um and videos, and then uh you can reach out on pluralconsult.com and you can reach out and email me directly.
00:31:38.880 --> 00:31:46.000
But um, yeah, I mean one thing I I would say just to leave you with is is you know most practices aren't losing revenue because their teams are failing.
00:31:46.160 --> 00:31:49.680
You know, I I don't ever blame the the practice owner, it's hard.
00:31:49.759 --> 00:31:53.839
Um, they're losing it because the payers process is better organized than their own.
00:31:54.559 --> 00:31:55.200
Thanks, Ryan.
00:31:55.359 --> 00:31:56.400
You have a good afternoon.
00:31:56.559 --> 00:31:57.599
Thank you, Nathan.
00:31:58.400 --> 00:31:59.440
And thanks for joining us.
00:31:59.599 --> 00:32:03.759
Revenue Cycle is where the money lives, guys, and now you know what to look for.
00:32:04.079 --> 00:32:06.319
Thank you for joining us on the Snap Scale Show.
00:32:06.480 --> 00:32:11.200
We hope today's discussion inspired you to take your next step forward towards a healthier organization.
00:32:11.359 --> 00:32:17.279
Because healthier organizations create stronger teams, better patient experiences, and ultimately better care.
00:32:17.519 --> 00:32:24.079
If you enjoyed this episode, subscribe, share it with another healthcare leader, and we'll see you next time on the Snap Scale Show.