decisionhealth Newsletters, Part B News - 2016 Issue 10 (October)
The Stark Reality: Costly mistakes with collections, contract review, communication
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Article Overview
This article reviews revenue audit findings from a medical auditing and consulting firm, focusing on operational issues that can affect practice revenue and administrative efficiency. It is relevant to practice managers, billing teams, and physicians involved in revenue cycle oversight, contract monitoring, and coordination with hospitals or third-party billing services. The guidance is broad and operational, emphasizing monitoring, review processes, and communication practices.
Why This Topic Matters
The article addresses common nonclinical revenue-cycle problems that can lead to lost income, denied payment, or strained relationships with hospitals and vendors. It helps readers understand why oversight of billing workflows, contracts, and internal communication is important to practice stability.
Article Sections
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Audit No. 1: Collection agency errs, risks $565K
Discusses a collection agency reporting issue, the audit process used to verify account volume, and the broader importance of reviewing collection activity.
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Audit No. 2: Intense review of new contracts
Covers a contract-related payment problem, the audit review performed to identify the issue, and the need for careful monitoring of contract changes.
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Audit No. 3: Problems from poor communication
Describes a communication breakdown involving billing transitions, patient statements, and hospital administration, along with the resulting operational concerns.
What You Will Learn
- How collection reporting issues can affect revenue oversight
- Why contract review matters when payment patterns change
- How communication gaps can disrupt billing operations and hospital relationships
- What types of administrative controls support revenue cycle monitoring
Who Should Read This
- Practice managers
- Billing managers
- Revenue cycle staff
- Physician group administrators
- Hospital-based group leadership
- Medical auditors and consultants
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