There’s so much more to a successful medical practice than just quality patient care. Behind the scenes of every appointment, every billing cycle, and every patient satisfaction survey lies a multitude of administrative tasks that can either make or break a successful medical practice.

There are few medical professionals who pursue this career path because they want to create spreadsheets; most people go into medicine to provide patient care and health services. At the same time, there are few practices that succeed without equal consideration of the administrative side of delivering that care.

Patient Scheduling and Appointment Management

One of the most effective ways a practice can earn more revenue and keep patients satisfied is through patient scheduling and appointment management. At first glance, scheduling seems simple—creating time slots for appointments and filling them in—but there are far more effective ways to manage appointments that allow for more revenue through higher quality time spent with patients.

For example, effective practices increase revenue by 15-20% merely from proper scheduling. This includes consolidated procedures, adequate time for annual appointments (instead of rushing through so the provider can meet their next patient), and systems in place to backfill for openings. When patient scheduling is done properly, everything else tends to follow.

Insurance Verification and Prior Authorization

There are few things worse for a provider than having a patient walk into a visit anticipating insurance coverage only to have the professional inform the patient that it does not exist or that the policyholder failed to get a prior authorization to receive services. This leads to provider/recipient tension, delayed payments, and a potential loss of revenue.

The best practices verify benefits before patients set foot in the door, on top of navigating the necessary prior authorizations. The best practices even go the extra mile and hire specialized clinical support services to ensure this process is done efficiently and accurately so providers don’t waste precious time creating their own authorizations.

Medical Billing and Claims Processing

Perhaps one of the worst nightmares for any practice is having an associated medical bill get lost in the shuffle leading to either a time–consuming appeals process or thousands of dollars of lost revenue due to error. Unfortunately, medicine and bills are not straightforward; there are codes, rules for which types of paperwork must accompany others, stricter regulations and constantly changing policies.

Therefore, not only the most successful practices but those with the best intent also ensure they have specialized billing processes to manage their own claim submissions and accurate electronic health records. Medical professionals struggle enough treating patients; they shouldn’t have to double-check their own claims for secondary bills down the line that won’t go through unless they’re submitted properly the first time.

Patient Communication and Follow-Up

It’s not enough for a successful practice to answer the phone when patients call; patient communication must extend after an appointment—to schedule tests, make follow-up calls about symptoms or appointments, inquire about medications, etc. Successful practices have systems established to ensure open lines of communication.

For example, a successful practice will implement an auto-calling system for appointment reminders while also having a robust website with information about upcoming holiday schedules (to manage potential COVID outbreaks) or flu shot scheduling. The best practices manage this communication well without adding more administrative burden onto their providers since studies show that when communication systems are strong, trustworthiness increases.

Compliance and Documentation Management

No one wants to be bogged down by compliance; after all, there are strict measures in place thanks to HIPAA that govern how and when information can be shared among parties. However, failing to stay up to date on industry changes can result in substantial financial penalties which could be more debilitating than extra paperwork.

While it may seem easier to ignore compliance documentation, it’s far better to stay compliant at all costs. It’s seen as part of patient care instead of nothing more than annoying bureaucracy keeping professional from getting down to business. Successful practices treat compliance as part of patient satisfaction instead of an operational necessity not related to what matters most.

Financial Management and Reporting

A successful practice knows where its money goes, how much comes in, how much is lost, where it should be allocated and why specific business decisions are made. It’s not enough to take a peek inside a bank account monthly; it’s necessary to generate metrics from operations like days in accounts receivable, cost per patient visit/revenue per staff/provider, etc.

All successful practices know how to generate these numbers from their systems; those that struggle lack attention to these financial details despite employees spending hours creating spreadsheets for other factors. It’s critical for proper planning for growth but also critical for cash flow stability.

The Interconnectivity Issue

Ultimately, the most challenging administrative tasks are those facilitated independently but requiring integration with one another. Patient scheduling impacts billing cycles and insurance verification impacts clinical efforts. Research shows when these processes are streamlined successfully, there’s less administrative burden for providers.

Administratively successful practices possess both detail-oriented minds while simultaneously working with big-picture ideas. No one can be focused on minutiae without effective integration toward an overall goal.

The practices that succeed in today’s world understand that behind every patient visit, billable service or positive recommendation is a whole network of effort under leading administrators. Without attention paid to administrative tasks beyond patient care most practices would flounder; when administrators successfully command all systems, medical professionals are free to do what they do best—and that’s how everyone succeeds.