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Overcoming Q1 Cashflow Challenges in Dermatology Practices

Inga C. Ellzey, RHIA, MPA, CDC

By February 1, 2023February 17th, 2023No Comments

Healthcare providers nationwide can anticipate a decline in payments from January to March 2023. Although any decrease in monthly revenue is significant, there are several important considerations to keep in mind.

  1. Patient deductible reset on January 1, 2023. Therefore, when patients come into your office in Q1, they must meet their deductible before insurance contributes.
  2. Year after year we’ve seen higher and higher deductible plans.
  3. Patients take longer to pay, and sometimes do not pay at all. The effect is that the provider is stuck waiting on patient funds instead of (more) reliable insurance payments.
  4. Additional factors may include:
  • Holiday closures in December which impact payments in January
  • Insurance companies are facing staffing difficulties nationwide, leading to prolonged processing times
  • Adverse weather conditions cause reduced operating hours for both healthcare practices and their payers.
  • Carriers that take longer to pay due to exhausting their funds for the year
  • Decreased appointments as patients wait to pay December bills before making appointments as they cannot afford the deductibles

Don’t worry! Similar to what a wise investor would advise, “stay the course,” and the revenue levels will return to normal by the end of March. In the meantime, here are a few strategies to help mitigate the decline in cash flow.

AR Cleanup

Unpaid bills can lead to a significant amount of stress and financial problems for a practice, and can negatively impact their ability to provide high-quality care to patients. A backlog of unpaid bills can also lead to an increase in administrative expenses and the cost of services provided, as staff members must spend more time and resources attempting to collect payment from patients. This can result in a decrease in income for the practice, which can be detrimental to the overall financial health of the practice.

Encourage your staff to clean up the Accounts Receivable. Make an effort to follow up on all outstanding claims that are over 30 days past the initial Date of Service. This ensures that you are actively pursuing payments for all eligible claims and helping to maintain the accuracy and organization of your Accounts Receivable records.

By taking these steps, you can improve your overall collection efficiency and maximize your revenue and your staff can focus on providing high-quality care to patients and growing their practice.

Review Write Offs

For claims that are older than one year, write them off to gain a clearer understanding of the collectible revenue associated with your Accounts Receivable. This reduces staff burden when reviewing the list each month making the Accounts Receivable report appear more manageable. It is recommended to implement measures to increase transparency ensuring you are aware when claims are written off due to non-payment.

Adjust your Fee Schedule

Update your fee schedule. Check out our post on the revised conversion factor and the best way to update your fee schedule to optimize your revenues:  Fee Schedule Update

Patient Statements

Issue a final notice to patients who have not paid after three statements (e.g., 90 days). If there is no response within 40 days, refer the debt to collections, write off the patient’s outstanding balance, and make a notation in their account to prompt staff to follow up if they schedule another appointment with your practice.

Payment Portal

Establish a patient portal if not already in place allowing patients to make payments online. Providing various payment options is beneficial as some patients prefer electronic methods while others prefer to pay via mail. By accommodating all methods, you can maximize patient collections.


By prioritizing the collection of copays and other payments at the time of the visit, utilizing a network of referral sources to bring in new patients, and implementing effective billing and collection procedures, you can improve the financial health of your practice.

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About Inga Ellzey and our Dermatology Billing Services

After 27 years of perfecting billing processes, Inga Ellzey continues to be the nation’s leading expert in dermatology billing. Her billing service serves over 100 dermatology practices in 37 states without utilizing any offshore labor. The goal is to make sure that you and your patients receive the most competent and professional service available in the market today.

If you are interested in speaking with our company about how we can maximize your collections while also improving your process, please contact us or call 888-434-4374.

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