Imagine being able to keep your healthcare practice financially sustainable while still serving the needs of your community. That's exactly what we're breaking down in today's recap of the last two podcast episodes. We're ripping off the bandaid and exposing the truth about revenue cycle management (RCM) in healthcare. A topic often overlooked, but it could be the key to preventing significant financial losses in your medical practice or hospital.
We'll probe the possibility of outsourcing billing to tackle unrecovered claims, and shed some light on why the medical community needs to strip the stigma around discussions of profit. After all, healthcare is a business, and to continue serving, it must be financially sustainable. Strap in as we demystify the intricacies of healthcare finance and its role in combating physician burnout.
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 passion for medicine. So why would a podcast centered around burnout and moral injury really look into revenue cycle management or RCM? One of it is that I don't think that we really understand it. I've been practicing post residency for 10 years and up until a few months ago I had no idea what that meant. It's not just as simple as we finish a note, we submit a claim and we get reimbursed. I had no idea that we had 20% to 30% laying on the table and, from any business aspect, it's really hard to keep any type of business open with that type of loss, and that's not even including the you know accounting for decreased reimbursement. So as we go through medical school and residency unless, I think, we look for these things we know what questions to ask we really are not taught about this. We're taught about the path of physiology, how to interview patients, which is great, but even if you're an employed physician, it's important that you understand how the clinic or hospital is reimbursed. We know that knowledge is power and, as I've said that before, I think it's important to understand that it's not just about seeing patients and generating RVUs. Not that I agree with. We need to generate RVUs, but that's just the way it is, unless you're in a practice where you don't take insurance or there's a different way to get reimbursed. This is the way employed physicians at least, and also RVUs is how we are reimbursed, period. But let's say that we treat a patient and we just get 66% of the treatment right. That's not acceptable, and so getting paid only 66% for what we do is not acceptable either.
Dr. Shah-Haque:
So part of understanding the revenue cycle management is not just understanding the financial side, but also understanding of why it matters. It matters because it allows the hospital or clinic to keep their doors open in the community to take care of patients. It allows us as physicians to be part of that healing community. And it's not just that. It's also about practice efficiency from the front desk to the back end and then when the patient leaves the clinic or hospital, and also the reimbursement We've covered. How we can address leaving 20% to 30% on the table and outsourcing that part of the billing might be an answer, and if it's not, fine. But how is the business going to address the claims that are not recovered? The second thing is that it's also being part of the community, understanding that profit is not bad, it's not an evil word. Talking about money is not an evil word. It keeps you in business, it keeps you or employed and it keeps you able to keep serving your community as a physician, as a member of that community that might actually consume that service or be a patient, because, remember, we're not invincible, we are patients as well and I doctor where I live, which is in a small town community.
Dr. Shah-Haque:
In the next two weeks we'll be looking at practice efficiency as well as reducing overhead. And why does that matter? Because we are already busting our tails. So, like anything else, like I'm an internist, so I have the regimen for diabetes, high blood pressure, I have that regimen down right. How I treat patients, how we approach that, there's an algorithm for that. There's first line, second line, third line. It should be the same way when we approach the practice of medicine. How can we practice efficiently, safely, but also reduce overhead cost?
Dr. Shah-Haque:
Now, sometimes it might not be possible, but business is a type, or medicine is a type of business, unless we're giving our time, talent and treasure away for free and even then it's a donation. That charitable organization is still a business. So you can look at medicine as a business that gives a service to a community that needs it, probably now more than ever, without looking at describing a business model or discussing business principles as a dirty word or no. That's not the reason why I went into medicine. They go hand in hand. You can be ethical about both.
Dr. Shah-Haque:
So, as we go forward in the next two weeks, looking at efficiency and medical practice, as well as how to reduce overhead and maybe use some tools to main light or streamline some of these processes, I really want you to focus on Would this be a solution for me and how does this combat burnout? Well, you're already doing a service. Are you getting paid at the fair maximum capacity Again, fair. You want this to be fair and ethical because if you're not, then you need to make sure that you're getting paid fairly. Also, remember you're not just a physician. You're part of a community, You're part of an ecosystem, and it is so difficult at times to manage multiple aspects. So we're looking at ways to try to mainstream and Improve efficiency. It does not mean that you're not efficient. That's looking at what are things that can be done in order to Look at gaps where maybe we can fill those gaps with more efficiency or Kick that up to 95% and set up 90%.
Dr. Shah-Haque:
Physicians are some of the most resilient human beings on this planet. With the courses that we have to take to get into medical school, the extra studying, the extra classes, the extra experience whether it's research or clinical Experience and then on top of that the amount of information that we consume in medical school on top of residency, it's not a lack of resilience. But also let's be mindful that it is also important that we have understanding of the business side of medicine, because that is the true world in which we operate. If you find have found this helpful, like share with a friend, because we can all use some camaraderie. I.