Step One in the Holy Grail of Great RCM: Contracts

Do you know where your children are?

Mothers in the park know; teachers at the school know; even on a camping trip, you know where your children are: children are important and, like it or not, you’re responsible for them; when they run into trouble, you have to fix it or you are in for a miserable camping trip.

In the world of RCM,  contracts, like children, are important whether you like it or not and too many medical practices cannot answer this question:

Do you know where your contracts are?

Nor can they answer these questions:

  1. Do you know what your contracted rates are?  (Would you like to know what you get paid for a procedure?)
  2. Are they in a fee schedule?
  3. Are you familiar with the process requirements for claim submission within your individual contracts?
  4. Is each physician in your office properly contracted?
  5. Is your staff, billing and otherwise, conversant with your contracts? Could they find them?

You should know where your contracts are: what your rates are, what you’re getting paid per procedure, are you actually getting paid your contracted rate,  etc..  Your contracts are your children.  Where are they?  How is their health?  What are their grades?  What issues do you need to fix?  Like it or not, contracts are important!

Kids are better than contracts because they yell when they get hurt: they do what it takes to get your attention.  Contracts, on the other hand, don’t say anything –  you only figure out there’s a problem when you don’t get paid three months down the line.

Do you know where your contracts are? Are they okay? 

Or are you in for a miserable trip?

Billing Functions
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Brad Sclar has founded several successful Healthcare IT companies within the last 20 years in the Denver area — PRS Network, Phasis Group, and MD-IT. In addition to multiple IT certifications he supports voice recognition software into multiple EMR environments nationwide, serves as the CIO of the PRS IT Division, overseeing template development, maintenance of client LAN installations, custom software development, HL7 interfaces between EMRs, and the installation of the Health Record portion of the EMR software packages that PRS represents. Currently, he is involved in launching a Urology focused MSO.