RBRVS_AR I

The accounts receivable (AR) of a medical practice holds the key to success
or failure of the practice. It is the competitive edge when recruiting and
the buffer for slow times. Losing Control of the AR, risks practice value
erosion.  There are several ways to measure practice AR performance,
including "days in AR" as the most popular. These parameters will not be
part of this discussion, though if desired; a discussion of AR performance
is feasible.  

This discussion will focus on AR automation and RBRVS. AR automation
requires a discussion of electronic media claims (EMC) and electronic media
remittance (EMR) - NOT to be confused with electronic medical records. While
EMC has little benefit for small to medium sized practices, if does have a
marked benefit to the payer and some reward, such as prompt payment, is
often promised for those with EMC. EMR on the other hand carries an enormous
benefit to the small or medium practice and even greater benefit to larger
practices.  A well designed EMR eliminates 80% of the work and virtually
100% of the errors in posting payments. Serious benefits may accrue to
practices with a well designed EMR.

For purposes of the discussion an "integrated medical application" is an
application in which the medical record and billing component, including
registration, posting charges, payments and billing are all included in one
product without element duplication in another database. While programming
for an effective medical record is remarkably challenging, the programming
of a practice management product is relatively easy. Thus the medical
practice management software matured at least 20 years ahead of the medical
record products. To the best of my knowledge, not much new has happened to
the medical practice management systems in the past 15 years. On the other
hand, the medical record has experienced enormous growth and remains in its
infancy. This is the state of affairs as we approach the structure of AR,
medical practice management, and a FileMan based integrated medical
application - the subject of the next installment.



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