Case Study: Improving Medical Billing and Collection in a Psychiatry Practice

A psychiatry practice experiences significant improvements in turnover, collections and patient satisfaction.

Challenge: Medical Billing Challenges in a Pyschiatry Practice

Before engaging with Synchramed, this psychiatrist used a custom-built practice management application that was not updateable, and which was supplied by a vendor who did not provide aftersales service. Due to the application’s subpar integrations, the doctor had incomplete insight into the status of claims submitted by the practice to the patients’ medical aids, and as a consequence situations requiring follow-up were easily missed. Not only did this delay the reimbursement due to the practice, but it also created aggravation for the patients.

Over time the application grew incompatible with current medical coding guidelines, and its medical aid rates infor-mation became outdated. It also lacked the ability to report on monthly revenue, outstanding balances, and payments.

In short, the doctor could not rely on the software to provide a basic overview of the practice’s financial performance.

Solution: The Synchramed Practice Management Solution for Psychiatrists

Through close consultation with the doctor and an investigation of the hindrances being experienced in the practice because of the shortcomings of the software, it became clear that the best path to resolving the situation was for the Billing Specialist team at Synchramed to take over the account administration.

With visit records being forwarded daily to the team, timely and accurate digitalisation could take place, and follow-up with the relevant parties could take place in real time, lightening the doctor’s administration load. The accuracy of the billing would benefit greatly from the frequently updated industry data marshalled within the Synchramed practice management software.

Furthermore, the collection of outstanding accounts would be taken over, harnessing the extensive experience, adeptness and perceptiveness of the Synchramed Credit Control team.

Results: Improved Financial Performance in a Pyschiatry Practice

Taking stock after handling the doctor’s accounts for a month, the doctor’s turnover was just over R300k — a figure we knew could be significantly improved. We assisted the doctor in signing up with all the applicable medical aid designated service provider agreements to create better visibility amongst scheme members. This is a very effective means to growing a stable core within a doctor’s patient database. The average monthly turnover has grown to exceed R500k, with a net collectable book of less than R300k. The average collection percentage is 99.5%.

The doctor receives monthly reports that track a large spectrum of key performance indicators:

• Revenue
• Payments
• Value of outstanding accounts
• Number of visits
• Average rand value per visit

These reports give the doctor the full picture on the practice’s financial position. Many of the reports can also be drawn day-to-day, giving the doctor all the information necessary to monitor how well the Synchramed medical billing and collections team are keeping tabs on outstanding monies.

Last, but not least, patient satisfaction has responded positively to the attention to detail being brought to bear in the practice administration, which is also being seen in the energetic growth of the patient database.