I’m hoping you’ve been on NNPEN’s website recently and found our new menu tab: Business Services. But maybe you haven’t. In any event, NNPEN wants you to know why we are moving into this space, and the role we think NNPEN can play to make practice start-up easier.
Like every good business owner, you want to ensure your practice is running as smoothly and efficiently as possible. However, with the numerous requirements and nuances they don’t teach you in nursing school, it can seem daunting to run a successful business on top of providing top-notch care.
NP business owners need to rely on trusted third parties to remain compliant and keep the doors open. NNPEN has identified two areas where a small investment in outsourcing will yield big dividends on your part: revenue cycle management (aka billing and collections) and credentialing.
Revenue Cycle Management
Because so many dollars and hours are at stake, revenue cycle management (RCM) is a priority for NP practice owners to investigate outsourcing. RCM’s aim is to maximize your reimbursement revenue. One stage in RCM where NP practice owners fall short is challenging claim denials; they’re not what NPs know, they can require aggressive moves, and they take time.
NNPEN partners with PRMS, a firm that is particularly comfortable challenging insurer denials because their medical record professionals are grounded in the patient’s medical record. We like this sweet spot: the industry estimates that between delays in hiring providers due to protracted credentialing timelines and the failure of providers to challenge claim denials, 30% of your gross collectable revenue is conceded to insurers here. This is money from your pocket just going free! Don’t be penny-wise and pound foolish; face up to the money you are leaving on the table!
Credentialing is important to understand but not to do yourself because the rules are arcane. Even small oversights/errors in the application process means the insurer will send your application back to square one. The longer the credentialing and contracting process takes, the longer it will take you to start generating revenue, whether it be for your services or for a new NP you want to hire. A credentialing service will track your application from beginning to end so that the needed badgering is done without sucking the energy out of your practice.
NNPEN’s partnership with nurse-owned credentialing service SBSC negotiated a material discount for a la carte credentialing services, priced at a $295 one-time provider set-up fee plus a $100 -per- application fee. Assuming you manage five applications through this system, $800 is the cradle-to-grave credentialing services cost that the NP needs to weigh against the value of her or his time.
What’s NNPEN’s Role?
NNPEN is not employing professionals with specific business services expertise, such as SBSC and PRMS. Our business model is that we find the best thoroughbreds and invite them into our stable as independent contractors. We are air traffic controllers with respect to their service delivery to you. We envision that we are a concierge service for you to find the right fit between vendors and you, and to be your mouthpiece when things go awry.
This business model of concierge services is not unique to NNPEN, but we embrace it – both because in our view it’s the right way to run our business and because it passes our smell test as a way NNPEN can earn the revenue we need to grow while furthering the business sustainability goals of our clients.
Next post will focus on the most developed business services NNPEN offers: Consulting with the Founders. WHAT we four gals know is valuable, and WHO we know is priceless. Need to know more right now? Contact us at firstname.lastname@example.org.