Isn't it time we broke the silence surrounding money in healthcare? Juli Quinn, President of GoSource, and I break down this taboo topic in an engaging conversation. We explore the vital role of financial management in healthcare, tackling everything from the importance of financial recovery for hospitals, clinics, and individual practices to the challenges of submitting claims and the crucial need for timely documentation.
Our conversation doesn't stop there. We dive into the pain points many healthcare organizations face and how bringing in a knowledgeable team for financial management can be the solution. Juli offers valuable insights about finding the right team to support your organization's financial journey, along with how GoSource can be an instrumental part of this process. We wrap up by discussing how to decrease the cost of collecting money, improve financial stability, and ultimately, make your healthcare practice more profitable. Because let's face it, a financially stable practice is better equipped to serve its patients. So, come join us, let's talk money and healthcare.
What You'll Learn: 1. What is RCM, or Revenue Cycle Management. 2. Why RCM matters. 3. What can understanding RCM and increasing profitability translate to clinically? 4. It's all about people, the patients, and the community at the end of the day.
Though I am a physician, this is not medical advice. This is only a tool that physicians can use to get ideas on how to deal with burnout and/or know they are not alone. If you are in need of medical assistance talk to your physician.
Welcome to another episode of the Worthy Physician. I'm your host, dr Sapna Shah-Haque, reigniting your humanity and your passion for medicine. Today we're going to start out with one of several in a series, and I am partnering with GoSource. Gosource should be your go-to source for RCM management, recovery and all things finance in that realm. The reason why I say that is because I think they approach this part of the business of medicine with ethics and compassion the same way we reach out to our patients. Today I have Juli Quinn. Thank you, juli, for joining me today. Can you please tell our listeners what your role at GoSource is?
Juli Quinn:
Yeah, I'm happy to be here, dr Sapna , chatting with you and sharing a little bit more about GoSource. I am the president and GoSource is a medical RCM company, but there's many RCM companies out there and what makes us different is, as you said, we are the company with a heart and a passion for what we do, because it's about people. You deliver medicine and you have to be able to get paid for that. We do the business side, but we're doing it also for the patient. The main outcome is we want the patient to have a good patient experience. You take care of the medical side, we'll take care of the finance side. Patient is happier and the practice is successful in having to balance those two. Yes, we are definitely thinking about and participating in the relationship as well as just going through the motions of the paperwork necessary in this RCM cycle.
Dr. Shah-Haque:
I truly believe that and appreciate that because we've had multiple conversations over the last several months. It always goes back to people. Now, one thing, doctors, I'm just going to say it right off the bat one thing doctors don't like to talk about is money. It's because I truly believe it's not because it makes us uncomfortable and we don't like to discuss it because it's a taboo topic. I truly believe it's because most of us went into medicine to heal people. Where we consider ourselves healers, there's a lot of altruism. It sounds like it's a dirty transaction when you talk about money, but I think by hopefully by the end of this series, the listeners will understand that it's not a taboo topic. It really goes back to if you want to keep the doors open and you want to keep the practice open, you need to have that discussion. We're going to normalize that. We're going to normalize that by starting with the biggest question why should I care about how much the hospital or the clinic or the practice is recovering?
Juli Quinn:
That's a very important question. We typically deal with these practices as you mentioned. We'll deal with health insurance, which you are already taking a discounted rate for your services because you're on their plan. Let's say, for example, a doctor sees a patient for their annual wellness exam and you submit whatever your fee is to the insurance and they're going to approve about $150. Regardless, if you submitted $150 as your price or $250 as your price, you have pre-agreed that you will accept their rate. Now that is contingent on all the steps of dotting the I's and crossing the T's were followed in submitting that to the insurance. If not, then they will deny the claim. So we find in the United States as a whole all states that about 30 percent of claims are going unpaid. That is significant. That's a lot of money. If you saw nine patients today, imagine you only got paid for six and that's really hard to keep the doors open, working on 66 percent of an already discounted rate.
Dr. Shah-Haque:
So about 20 to 30 percent is just left on the table, correct? That's infuriating, because you can't Nowhere else really. Can you go and say I'm only going to pay for two thirds of my meal, or my hotel stay or my trip?
Juli Quinn:
And the reason that it's left on the table is because it's very expensive to go after those that have been erroneously denied or often it's not really a denial, it's just pended for more information. But if the hospital or the clinic or the physician's practice does not have the resources to do those second touches or, in some cases, a third touch, it just doesn't get paid. And it's often a misnomer that I don't want to spend $10 to collect nine, so they just don't do it. But there are ways to get it done that it does not cost as much as what you're recovering, and those are some things we'll be talking about.
Dr. Shah-Haque:
But another thing is trying to get those claims and submitted in a timely manner. And you're talking about you probably need the clinic note in order to send that or at least go back for more information. That is correct.
Juli Quinn:
The doctor's note is critical to the billing process. I'm sure you've heard, your listeners have all heard when you go to your seminars. If you didn't document it, you didn't do it. So this is the biggest challenge when I do consulting with doctors be thorough and close those notes quickly so that the rest of the billing process can take place with highest level of success.
Dr. Shah-Haque:
Yeah, it's the bane of our existence. Right, the documenting? Because, yes, we are operating in a time where EHR is a must, unless you do direct care. Having said that, there are tools and we've all referred to them in the show notes. But, going back to the episode with Dr Mary Lung, who is also a physician and coach, you can optimize ways to get your notes done in a timing manner. Also, there is AI, so there are resources out there.
Dr. Shah-Haque:
It's just a matter of how do I incorporate that into what I'm already doing? I know we will try to weave that in and answer those questions further. But, to summarize, 20 to 30% is left on the table for work I've already done and it's expensive to claim that, and we're going to get into some areas in the very near future as to how we can decrease that cost and make it more profitable and yes, we're using the word profit here in a podcast geared toward physicians P-R-O-F-I-T, because that is what keeps the doors open, that's what allows the hospitals and clinics to be able to keep their doors open and keep us physicians being able to take care of patients. So we can't treat the body and mind differently or separate. We cannot treat the financial side of a practice or a hospital separate from the clinical side? Absolutely so.
Dr. Shah-Haque:
It helps the bottom line, but also it's important. How important is it You've been in the consulting realm of working with physicians and clinics? How important is it that physicians get paid and I know this is going to be a. This is probably a rhetorical, eye-rolling question, but it's one that I think we need to talk about openly. What have been your experiences with that and what answers do you have to that for physicians?
Juli Quinn:
As you said, in order for us to serve patients, they were serving the community. In order to do that, we have to have support staff, and we need good support staff. Every physician, from your person making your appointments on the telephone, your front office staff, your back office staff, your business office all of these people are needed for this whole process to work successfully. And then there has to be payment for the physician. You have bills to pay as well, so you need to have an income that is sufficient for everybody in this whole lineup, and the more poor people we have and the better job they're doing, the more patients we can serve. So it actually is to our benefit to have a really good system and be scalable, so that if we want to be able to increase our patient load, we can just plug in more people in each of those steps of the process, including additional doctors to bring in Some community areas I believe you, dr Safinarin a more rural, underserved area.
Juli Quinn:
You might have a shortage of doctors, so you'll have a need to have more people on your schedule than perhaps a doctor that's in the city that can say oh, I'm only going to take a patient every 30 minutes If there's enough doctors to serve that community to be able to have that schedule great. But what if we need you to be able to see two or three patients in that timeframe? We need support staff. So profit is equal to growth of ultimately serving more patients.
Dr. Shah-Haque:
I'm thinking for bringing that up, because, practicing in real time, one of the biggest issues is staff retention. It is staff retention and this is across the board. We're seeing rural hospitals, clinics, solo practice clinics that have really been pushed to either sell or on the verge of closing or selling because of that bottom line not being hit. And so I'm going to flip this and, for the listener, I'm not advocating corporatization of medicine. I'm advocating an ethical approach to get paid for the work that we're already doing but be time efficient and cost efficient, because if we want to grow our capacity to serve patients in a timely manner, even if it's just the ones you have, you still need the staff. And everywhere we're looking there's a staff shortage because of lack of benefits or pay, or I just simply don't want to. It's a multitude of things, but one thing that we can attack is if we can collect more in an efficient, especially cost efficient, time efficient manner that allows for more growth and, hopefully, proper staffing.
Juli Quinn:
Right and if you can increase your revenue 20%, you could give raises to your star performers and keep them engaged in the long-term relationship. You could attract new staff members, you could attract new positions to your area because it will show the stability that we are here. We have a good service, we have a need and we are viable, business wise, to stay for a long time.
Dr. Shah-Haque:
So RCM is really the financial backbone of medicine, whether it be clinical or whether it be the hospital. And again, I think it's a series where we're not too sure if we understand it. We have to understand every piece, but the truth is, I think, just understanding the importance and understanding that you've been in this business for 20 plus years, so it's not like this is just overnight. This is your career and every place that you've worked, these are the percentages that are coming up. That's concerning. Again, there's no other area where you get paid for 66% when you're going to get 100%.
Juli Quinn:
But the news is there are solutions and GoSource is one of these solutions and what we can do is get those claims out to the insurance carriers. Claim claim as much as possible upfront, timely and then immediately quick response to any rejections. That is the key because these insurance companies have a time clock that many are 60 or 90 days, that they need to have received it in what they consider a clean claim, meaning there's all the correct codes and modifiers and patient can be identified and all of the just basic elements of the claim are accepted into their system by that date or you forfeit the opportunity to be paid. So that is critical, that those upfront systems are in place. But then what we specialize in is the 30% that is being asked for additional information or erroneously denied and we're not going to accept that. We're going after those. We're going after those very aggressively and early. The earlier you catch those and resolve them, the higher level of success for recovery. So we'll fight them to the very end and get majority results.
Dr. Shah-Haque:
Again, going back to ethics. You want the best for the patients, you want the best for the physicians and the clinicians. And again it's about ethics. It's a little bit unethical to not get paid for what you're doing. So you're optimizing options and through that, when you utilize efficiently and effectively, that increases the opportunities that physicians and the staff have within their community, again to provide care. That's why we went into medicine. So, again, not to demonize the word money or profit, it is not because we went into medicine to make money. Heck, we come out with hundreds of thousands of dollars of debt, right, and we're paying that off until God knows when. And the point is to stay and have that edge, keep our head above water, hopefully in a nice relaxing, floating way, instead of having to tread water for month to month. Julie, how can the listener reach out to you and how can we reach out to GoSource?
Juli Quinn:
Oh, thank you. Our website is Go, so iin notcomn and you can go to our website. You can request it more information and we'll set up a discovery call. Talk about what your needs are, what your challenges are, your pain point, and we can then talk about what we can do and decide together if it's gonna be a good fit.
Dr. Shah-Haque:
Thank you very much. And for the listener, what is one last pro of wisdom that you would love to leave the listener about? About RCM and about finances for practices in hospitals.
Juli Quinn:
You can have a successful financial side to your practice and if you surround yourself with knowledgeable people that are really passionate about bringing in the money for the work that you did, that you are passionate about taking care of patients, find a team that is equally as passionate, and together you'll be able to stay treating your patients and having a profit at the end of the day.
Dr. Shah-Haque:
Thank you very much for that. Again, it's not to demonize, but it's just a topic that we're so uncomfortable to discuss. But I think it's so important, and especially in today's world, in order to stay afloat if you're a small practice and an independent practice or if you are in multi-specialty or even the rural hospitals the larger entities are. It is tough. It is tough and we all want to do our best, and if we can alleviate one area of hurt and I think all businesses are hurting right now financially, so this could be a very good long-term cure for that financial hurt. So thank you very much, julie, and the links will be in the show notes. If you have found this helpful, like, share with a friend and click on the link in the show notes. This is another episode from the Worthy Physician. We can all use some camaraderie.