Tom Ferkovic is a seasoned healthcare executive with over two decades of experience. He currently holds the position of Chairman at Medic Management Group, a role he has held since March 1999. With a background in pharmacy, having earned his Bachelor of Pharmacy from the University of Toledo, Tom brings a unique perspective to the healthcare management field.
Throughout his career, Tom has demonstrated a keen understanding of both the clinical and business aspects of healthcare. His expertise in financial analysis, management, and practice management has earned him numerous endorsements from his peers. His articles on topics such as the alignment of behavioral health and primary care, and the changes in Medicaid coverage, reflect his deep knowledge and thoughtful insights into the current issues affecting the healthcare industry.
Tom is also known for his people skills. Colleagues describe him as a leader who “gets it”, understanding the nuances of medical practice and adding value not only through best practice application but also through “best people” implementation. His ability to attract and motivate high-quality individuals is a testament to his leadership style.
In addition to his role at Medic Management Group, Tom is also a member of Medvale. His contributions to the field have not gone unnoticed, as evidenced by his team’s recent recognition as a top workplace.
In our interview, we’ll delve deeper into Tom’s insights on healthcare management, his approach to leadership, and his views on the future of the industry. Stay tuned for an enlightening discussion with one of the leading figures in healthcare management.
Thank you for taking time to share your knowledge and experience with our audience. Can you start by telling the audience about yourself?
I am a pharmacist by training and was promoted through the healthcare system at St. Luke’s Hospital in Cleveland, Ohio. It was at St. Luke’s that I was asked to help physicians be successful in their practices. This was during a period of healthcare reform known as ‘Hilary Care’. The environment was a change to HMO’s and primary care, with physicians and hospitals exploring risk based reimbursement models. Companies such as PhyCor, Medpartners and other privately backed companies were consolidating practices. I started with practices at St. Luke’s and then joined a PPMC (physician practice management company now called MSO’s) known as Telesis of Ohio as president. Telesis was able to acquire and form an IPA that managed 30,000 lives in a risk model.
I see my career as helping physicians be able to help all of us be healthy. My drive has been to give the providers the ability to be successful in the clinical and financial model that makes them happy.
Can you tell our audience about Medic Management? What is the problem it is addressing and how is it doing so?
The business of medicine is complicated. Certainly, physicians are very smart and can learn the business of medicine given the time, however, when seeing 30 to 60 patients a day and then following up with notes, calls and administrative issues there is little time to run the business. The saying is we should ‘work on the business, not in the business’. Unfortunately, physicians cannot not do that as effectively as other businesses. That is where Medic Management Group helps. We have built an outsourced model that can assist physicians and hospitals with the management of their business allowing them to focus on the patient and as much of the business as they would like. Medic Management Group has helped practices and hospitals in 26 states.
Medic Management uses experienced managers, information, and listening skills to assist our clients. We have been in business for over 24 years and have a good understanding of the issues surrounding provider practice and a vision of the future.
What are the key components of revenue cycle management in medical billing, and why is it crucial for healthcare organizations?
The basics of revenue cycle management are known to all organizations; the differences between successful organizations and others are leadership, people and accountability. Implementing good processes and having the team to execute the processes are what results in great results.
Revenue cycle management (RCM) in medical billing encompasses various processes, including patient registration, insurance verification, charge capture, coding, claims submission, payment processing, and denial management. It is crucial for healthcare organizations as it directly impacts their financial performance and sustainability. By effectively managing the revenue cycle, organizations can ensure accurate and timely reimbursement, minimize denials, and optimize cash flow. RCM enables healthcare providers to track and analyze key financial metrics, identify areas for improvement, and make informed decisions to enhance revenue generation.
How can healthcare organizations optimize their revenue cycle management processes to improve financial performance?
To optimize revenue cycle management, healthcare organizations should focus on several key areas. First, streamlining the patient registration and insurance verification process is crucial to ensure accurate and complete demographic and insurance information. This can help prevent claim denials and reduce rework.
Second, implementing robust coding and documentation practices is essential for accurate and compliant billing. Regular audits and education for coding staff can help identify and address any coding errors or documentation deficiencies.
Third, leveraging technology solutions such as electronic health records (EHRs), revenue cycle management software, and automated claim scrubbing tools can improve efficiency and accuracy. These tools can help identify coding errors, verify insurance eligibility, and submit clean claims.
Additionally, organizations should establish effective denial management processes to identify root causes, implement corrective actions, and minimize revenue leakage. Finally, ongoing monitoring and analysis of key performance indicators (KPIs) can provide valuable insights into revenue cycle performance and guide continuous improvement efforts.
These processes and tools are only as good as the team executing on the information. Good management of the team, internal audit processes, accountability are what sets a team apart.
What are some common challenges or roadblocks that healthcare organizations face in revenue cycle management, and how can they overcome them?
Healthcare organizations often face several challenges in revenue cycle management. The first usually starts with under staffing or not segmenting the different skill sets that are required. Payment posting is different from AR follow up which is different from coding, etc. The second is the lack of automation in processes, and the final is a feedback loop to ensure that processes are followed/fixed.
With the increasing complexity of insurance plans and reimbursement models, how can healthcare organizations ensure accurate and timely billing to maximize revenue?
Most people would answer this questions using terms such as timely billing, eligibility verification, denial management etc. I believe that while these processes are correct, those are the standard.
Again, management of the processes and team are vital. First, investing in the team, tools, training and reporting is very important. Expense management in this vital area is not the first strategy. Make RCM a priority. The return on investment in this area easily pays for the investments. This starts with having the right team, working on the right things, assigned to the skill set. Ask not what it costs me to collect, ask how much am I collecting?
What role does technology play in revenue cycle management, and what are some innovative solutions that healthcare organizations can leverage?
Technology is evolving with the advancement of AI. However, we are still in early stages of automation compared to other industries. My recommendation is to not start with the technology and look for a problem to solve but review all aspects of the RCM and practice management process, determine the problem then search to see if technology can help.
In light of the COVID-19 pandemic, how has revenue cycle management been impacted, and what strategies can healthcare organizations adopt to navigate these challenges?
The biggest change due to Covid is the advent of remote work. RCM teams can perform their work remotely if the proper management systems are in place.
The COVID-19 pandemic has had an impact on revenue cycle management in healthcare organizations. The shift towards telehealth and virtual care has necessitated adjustments in billing and reimbursement processes. Organizations have had to quickly adapt to new coding and billing guidelines for telehealth services to ensure accurate and compliant claims submission.
How can revenue cycle management contribute to patient satisfaction and engagement, and what strategies should healthcare organizations consider in this regard?
Revenue cycle management can significantly contribute to patient satisfaction and engagement. By implementing patient-centric strategies, healthcare organizations can enhance the financial experience for patients and improve overall satisfaction. One strategy is to provide transparent and easy-to-understand billing statements.
Clear explanations of charges, insurance coverage, and payment options can help patients better understand their financial responsibilities and reduce confusion or frustration. Offering online portals or mobile applications where patients can access their billing information, view payment history, and make payments can also improve convenience and accessibility.
Looking ahead, what trends or developments do you foresee in revenue cycle management, and how can healthcare organizations prepare for the future?
Looking ahead, several trends and developments are shaping the future of revenue cycle management in medical billing. One significant trend is the increasing focus on value-based care and alternative payment models. As healthcare reimbursement shifts from fee-for-service to value-based models, organizations will need to adapt their revenue cycle management processes to align with these new payment structures. This includes capturing and reporting quality metrics, managing risk-based contracts, and optimizing revenue capture under value-based reimbursement methodologies.
Another trend is the continued advancement of technology in revenue cycle management. Artificial intelligence and machine learning algorithms will play a more prominent role in automating coding and billing processes, improving accuracy, and reducing manual intervention. Predictive analytics will enable organizations to proactively identify potential denials, optimize pricing strategies, and predict patient payment behaviors.
Lastly, regulatory changes and compliance requirements will continue to shape revenue cycle management. Organizations will need to stay updated on evolving regulations, such as changes in coding guidelines, billing requirements, and privacy regulations, to ensure compliance and minimize compliance risks.
In summary, revenue cycle management in medical billing is a critical aspect of healthcare organizations’ financial success. By optimizing processes, leveraging technology, and prioritizing patient engagement, organizations can enhance their financial performance, improve patient satisfaction, and navigate the evolving healthcare landscape with confidence.
Contact Details
- Business website: www.medicmgmt.com
- Business phone and email: 234-466-1034 & tferkovic@medicmgmt.com
- Tom’s Linkedin
