Reengineer Sleep Center Revenue

With the proposed cut in the standard growth rate for Medicare reimbursement, sleep centers are looking for ways to trim costs without sacrificing patient care and satisfaction. Kathryn Hansen, BS, REEGT, CPC, shared these tips from her 45 years of health care and sleep management experience:

Look for rework or redundancy in processes. Eliminating paperwork or oversight that doesn’t add tangible value can save staff time, resources, and money.

Collect copays/coinsurances upfront. Making sure patients know what amount they’re responsible for and are able to pay these costs before the appointment can help avoid problems with patient collection down the road. Before you begin, check your insurer contracts for restrictions.

Bill every 15 days instead of every 30. Shorter billing cycles can help get revenue in your coffers quicker.

Keep your accounts receivable under 45 days. Allocating staff to review accounting and the patient’s physical health and to set up patient payment plans can get accounts paid.

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Get on contract with third-party payers. Out-of-network billing charges can discourage patients from visiting your practice. Get in-network by requesting the insurer add you to their network, or, if they have a closed panel, partner with a practice in their network to provide services.

Increase education. In an attempt to convert up to 75 percent of patients to home sleep studies, third-party payers are beginning to require pre-authorization for in-laboratory studies. Practices will need to ramp up education for sleep technologists. “Out-of-center testing takes a more technically savvy technologist than in-center testing because there is more troubleshooting that needs to be done in a less than predictable settings,” Hansen said. Sleep technologists should learn how to reduce technically inadequate studies and to rule out false negative and false positive results.

Focus on home sleep testing.
Invest in home sleep testing equipment. Roughly 40 percent of Hansen’s patients tested out of center came back for a titration study in lab. “That is a tremendous clinical opportunity and inherent in that is a financial opportunity,” Hansen said.

Kristen Ziegler can be reached at [email protected]