Practice Management Alert

So you-ve weighed the pros and cons of real-time claims adjudication, but you-re still not sure if this up-and-coming process is right for your practice. Take a look at how Greenville Ear, Nose and Throat Associates in South Carolina increased collections and streamlined office efficiency with RTCA.

How they started: The practice used a few different approaches to implement RTCA with their payers. With Blue Cross of South Carolina, Greenville Ear, Nose and Throat had a payer representative help with set up and training over the phone. "We worked with someone over the phone who actually took our routing slip and created one in our Web portal so that our charges are built in to the portal," says Chris Plemons, practice administrator of Greenville Ear, Nose and Throat Associates.

When the practice began RTCA with UnitedHealthcare, however, the office personnel just "went in the site and started doing it. We didn't even make a phone call," says Doral Davis-Jacobsen, BHS, MBA, CMPE, manager of the physician services consulting unit of Dixon Hughes PLLC in Asheville, N.C., who helped Greenville Ear, Nose and Throat Associates implement RTCA.

Good tip: You need to be patient and expect some glitches. There are times when the system is down or something else will go wrong -- plus change is difficult, Davis-Jacobsen says. "If you stick with it and persevere, you-ll see great results," she adds. Incentives and rewards, such as bonuses tied to increased collections, can help smooth the transition for your staff.

The results: Greenville Ear, Nose and Throat Associates saw doubled collections in just one year. The practice began using RTCA in July 2007. "Our front-end collections, which means people who work at either check-in or check-out, saw an almost 100 percent increase from January of last year to January of this year," Plemons says. "We went from about $111,000 to about $205,000."

Greenville Ear, Nose and Throat Associates collects an average of $1,000-$1,500 per day on deductibles and co-insurance "that we never would have known about" at check-out, Plemons says. Keep in mind that this number will decrease over the course of the year as patients meet their deductibles. "The time to get the most bang for your buck is the first part of the year," Plemons adds.

In addition, the practice has seen a decrease in the number of claims that go to collections. Most of Greenville Ear, Nose and Throat Associates- accounts receivable is sitting in the zero-to-30-days category.

Bonus: "The big surprise that we had was the increase in patient satisfaction," Plemons says. "We thought patients would be taken aback or reluctant about the change, but they-ve been overwhelmingly impressed and extremely satisfied."

Moving forward: The practice is trying to get its other payers to offer RTCA as well. "Once a practice starts doing real-time claims adjudication, they-ll never go back because they aren't chasing money on the back end," Plemons says.