From the Field
During my time working for a third-party billing company, we have had many nephrologists come to us because their practice manager or biller had left and they did not have a plan in place for what they would do if their revenue cycle was missing a vital component. Resilience is vital for nephrology practices to withstand unforeseen challenges. This article explores strategies such as cross-training medical billing staff, software backup systems, password backups, and robust administrative processes and procedures to build a resilient practice.
Medical billing is a critical aspect of any nephrology practice. Ensuring accurate and timely billing is essential to maintain cash flow and avoid potential financial pitfalls. To promote resilience in this area, it’s important to cross-train your medical billing staff, so they can competently manage different aspects of the billing process. For example, cross-training billing staff to understand both inpatient and outpatient billing for procedures such as hemodialysis, peritoneal dialysis, and kidney transplant evaluations can prevent delays in reimbursements due to staff shortages or absences. Additionally, training staff to handle billing for various insurance providers, including Medicare and Medicaid, can help maintain a consistent revenue stream.
In addition to cross-training staff members, documenting processes and procedures relevant to charge entry, claim submission, payment posting and all other aspects of the billing process is a critical component of building resilience. Documentation should be detailed and clear enough that someone with no knowledge of the billing process could follow the documentation and successfully follow the billing process.
Software Backup Systems
The increasing reliance on electronic medical records and practice management software necessitates the implementation of comprehensive software backup systems. These systems should include both on-site and off-site backup solutions to protect against data loss due to hardware failure, natural disasters, or cyberattacks.
Nephrology practices can ensure resilience by regularly backing up patient records, billing information, and other crucial data. This can be achieved using cloud-based storage services or external hard drives. It is also vital to test your backup systems periodically to ensure that data can be restored quickly and accurately in case of an emergency. There are many third-party companies that offer options for storing and backing up data in preparation for unfortunate circumstances such as hardware failure or cyber-attacks.
Password Backups and Security
With the rise of cyber threats in health care, protecting sensitive patient information and practice data is more important than ever. Implementing a password management system, such as a secure password manager, can help prevent unauthorized access to your practice’s data. This should be combined with strong, unique passwords and regular password updates.
To enhance security, consider implementing multifactor authentication (MFA) for your practice’s software systems. MFA adds an additional layer of security by requiring users to verify their identity using a second factor, such as a fingerprint, a text message code, or a physical token. This can protect your practice even if passwords are compromised.
Administrative Processes and Procedures
A resilient nephrology practice requires robust administrative processes and procedures to ensure smooth operations during times of crisis or unexpected changes. Some key areas to address include:
- Contingency planning: Establish plans to handle staffing shortages, equipment failures, or natural disasters. For example, develop relationships with nearby physicians or hospitals to provide care to your patients if your clinic is temporarily unavailable.
- Regular audits and assessments: Conduct periodic audits of your practice’s billing and coding practices, as well as assessments of your cybersecurity measures. This can help identify areas of weakness and opportunities for improvement, bolstering your practice’s resilience.
By investing in cross-training, implementing robust software backup systems, enhancing password security, and establishing strong administrative processes and procedures, nephrologists can create a resilient practice that is better prepared for the uncertainties of the future. These measures not only protect your practice from potential disruptions but also contribute to a more efficient, secure, and stable nephrology practice.
Sarah Tolson is the director of operations for Sceptre Management Solutions, Inc., a company specializing in billing for outpatient ESRD dialysis programs, nephrology practices, and interventional nephrology. Your questions are welcome, and she can be reached at [email protected], 801.775.8010, or via Sceptre’s website, www.sceptremanagement.com.