The New Year’s Success Checklist For Medical Practice Management, by CBS Medical Billing

The new year is a nice time for reflection and renewal, a time to take stock and set forth. Medical Practices hoping to hone their management work flows and dial in their medical billing best practices should take the opportunity to review their process and policies so they can optimize their systems and start the year right. 

At CBS Medical Billing & Consulting, we’ve revised our much requested New Year’s Success Checklist, which has provided our partnered medical practices with a structured and actionable tool to kickstart their year with clarity and purpose for years. Now, we’re setting it free with the hopes that it helps as many medical practices as possible thrive in 2025! 

What Is The CBS New Years Success Checklist?

The CBS Success Checklist is a comprehensive guide tailored for healthcare administrators and practitioners, offering a step-by-step approach to address the 6 most critical areas in medical practice management: revenue cycle management, compliance, training, accreditation, contract reviews, and goal setting. 

Each component of the checklist is designed to ensure that practices are not only meeting industry standards, but optimizing their operations to improve efficiency, reduce errors, and achieve greater success.

How To Use The Success Checklist For Better Medical Practice Management

With this checklist, you can perform a soft audit on your medical practice management systems. It gives you a framework for proactively tackling operational challenges, streamlining billing processes, and maintaining compliance with ever-evolving healthcare regulations. 

Whether you’re managing a small clinic or a large healthcare facility, the CBS Success Checklist serves as a roadmap to enhance your practice’s functionality and achieve measurable growth in the year ahead. 

This blog goes line by line with the checklist, giving actionable insights into how to take on each task and why each category is crucial for your success this year.

At CBS, we know that the puzzle of medical practice management is a tough one, the pieces often seem scattered, and it can be difficult to optimize your business operations and patient care simultaneously. That’s why we do what we do – CBS Medical Billing is your medical practice’s missing piece.

Take some time to review the checklist, give it a try, assign tasks to your in-house admin team, and know that CBS is here to help if you get hung up.

Now that you’ve got the CBS Success Checklist, let’s go line by line, unpacking the key categories and tasks that your team should accomplish in order to optimize your medical practice management and make sure you’re up-to-date with medical billing best practices. 

1. Revenue Cycle Management

Optimizing revenue cycle management begins with a meticulous Work In Progress (WIP) review at year’s end. This process is essential to ensure no service goes unbilled and every patient’s care is properly accounted for. With that done, you can verify benefits, update forms, and assess your billing strategies to ensure that your practice is aligned with medical billing best practices. 

• WIP Review: This focuses on ensuring that all services rendered during the year are captured and billed. By closing out pending accounts, you can start the new year with a clean slate, minimizing the chances of revenue loss.
• Re-verifying Benefits: As patient insurance coverages can change frequently, re-verifying benefits at the start of the year is crucial. This proactive step prevents claim denials related to coverage issues, facilitating smoother and faster reimbursements.
• Updating Forms: Keeping patient financial responsibility forms up to date is vital. This ensures that billing corresponds accurately to the latest patient information, thereby reducing discrepancies and enhancing financial accuracy.
• Billing Strategies: Implementing robust billing strategies is key to maintaining a fluid revenue cycle. Effective strategies include detailed checks and balances to ensure all provided services are billed correctly, thus preventing financial leakage and contributing to a more manageable workload.

By putting these steps into your annual review, your medical practice can enhance its operational efficiency and ensure a solid foundation of ongoing financial health. These best practices in medical billing not only streamline processes but also significantly improve the accuracy of your financial operations.

2. Compliance 

Compliance is a key piece of the medical practice management puzzle. Annual reviews of your practice’s policy and procedure manual isn’t just a regulatory necessity, it’s a strategic action that safeguards the integrity and efficacy of your healthcare practice.

• Policy & Procedure Manual Review: This critical review ensures that all operational processes adhere to the latest Medicare standards and accreditation requirements. Regular updates to this manual help maintain compliance and reduce the risk of regulatory penalties. This review serves as a preventive measure, ensuring that your practice consistently follows best practices in medical billing and patient care management.
• Regulatory Alignment: Effective compliance includes aligning your practice’s operations with current HR and employment laws. Since these regulations can vary significantly across different states, it’s crucial to understand and implement relevant legal requirements. This ensures not only the protection of your practice from legal challenges but also fosters a trustworthy environment for your staff and patients.
• Continuous Updates: The healthcare landscape is continually evolving, and staying informed with the latest changes in state and federal regulations is imperative. By being proactive about regular updates, your practice can preemptively address potential compliance issues, ensuring seamless operations and safeguarding against compliance-related disruptions.

These compliance strategies not only help meet legal obligations but positions your practice as a reliable and ethical provider in the healthcare industry. Rigorous compliance measures are essential for sustaining a successful medical practice that upholds the highest standards of care. It may not always be the most exciting work, but it makes a huge difference in establishing a sophisticated and stable administrative branch of your medical practice.

3. Training

Practice makes perfect, effective training is pivotal. Not merely for meeting regulatory requirements, but as a fundamental component of effective medical practice management. Structured, annual training programs are essential for ensuring that all team members are up-to-date and aligned on the latest practices and technologies in medical billing and healthcare administration.

• Scope of Training: Comprehensive training covers a broad spectrum of crucial topics, including adherence to company policies, HIPAA compliance, updates in medical billing codes, and shifts in payer policies. This training ensures that all staff are knowledgeable and prepared to handle the nuances of medical billing and patient data management, thereby supporting the practice’s commitment to accuracy and legal compliance.
• Reducing Errors: Regular training sessions are key to reducing billing and operational errors within a practice. By routinely updating staff knowledge and skills, a practice can decrease the likelihood of costly mistakes and enhance the accuracy of its billing operations. This not only improves the practice’s financial health but also boosts its reputation with patients and payers.
• Enhancing Efficiency: Training plays a crucial role in boosting the overall operational efficiency of a medical practice. Well-informed and well-trained staff are able to perform their duties more effectively, which speeds up numerous administrative processes from billing to patient care management. This increase in efficiency can lead to better patient satisfaction and higher profitability.

When you train regularly, results follow. Incorporating timely training into the operational strategy of a medical practice is not just an investment in compliance, but an enhancement of the practice’s capabilities. This proactive approach to training ensures that your practice remains competitive, compliant, and at the forefront of the rapidly evolving healthcare sector.

4. Accreditation

In medical practice management, proper accreditation ensures that a practice not only meets but maintains the highest standards of healthcare delivery. Keeping accreditation manuals up-to-date is crucial for continuous compliance and preparedness for any audits or reviews that may come your way. In other words, accreditation keeps crises away – this is key for long-term stability of any medical operation, as an audit gone awry has sadly shut down plenty of otherwise great practices.

• Manual Reviews: Regularly reviewing and updating your accreditation manuals is essential. This ongoing process ensures that your practice remains in line with the latest health care regulations and standards. It also demonstrates a commitment to quality and safety in patient care, which can significantly enhance your practice’s credibility and trustworthiness.
• Scheduling Annual Accreditation Requirements: Ensuring your medical practice stays accredited involves more than just keeping your manuals up to date; it also requires meticulous scheduling and meeting various specific requirements throughout the year. Here’s a breakdown of common accreditation requirements that need to be scheduled annually:

• AD Requirements (Administrative Duties): These include tasks related to the overall management and administration of the practice. Ensuring that administrative records are in order, compliance with administrative best practices, and that all administrative staff are properly trained and up to date with healthcare regulations.
• HR Requirements (Human Resources): This involves ensuring that all human resources policies comply with current employment laws. Tasks might include updating job descriptions, conducting performance reviews, and implementing staff training and development programs.
• PC Requirements (Patient Care): These requirements focus on the quality and safety of patient care provided. Scheduling involves audits of patient care protocols, reviewing patient feedback, and continuous training for healthcare providers to ensure high standards of patient care are maintained.
• PM Requirements (Practice Management): This category covers the operational aspects of running a medical practice. It includes reviewing and optimizing operational procedures, ensuring financial management practices are up to date, and that the practice management software is functioning optimally.
• FS Requirements (Facility Safety): Safety audits of the physical facility to ensure that the practice meets health and safety regulations. This might involve checking fire safety systems, ensuring accessibility for disabled patients, and maintaining cleanliness and hygiene standards.
• CB Requirements (Compliance and Billing): These requirements ensure that the practice stays compliant with medical billing regulations and that billing practices are accurate and efficient. Tasks include auditing billing processes, updating billing codes, and training staff on new billing procedures.

Underscore your dedication to excellence and continuous improvement by prioritizing accreditation this year. This commitment not only supports regulatory compliance but also enhances the overall effectiveness and efficiency of your healthcare services, ultimately benefiting both the practice and your patients. Who doesn’t love a win-win?

5. Contracts

Managing insurance contracts is fundamental to the financial health and regulatory compliance of any medical practice. Annual reviews of insurance contracts are essential to ensure that billing and service terms are not only current but also optimized for the practice’s ongoing needs.

• Contract Reviews: It’s crucial to conduct regular reviews of insurance contracts to ensure they are up-to-date and accurately reflect any changes within your practice, such as service expansions or changes in healthcare regulations. This regular scrutiny helps avoid discrepancies that could lead to billing issues and ensures that the practice is always aligned with payer requirements.
• Proactive Adjustments: Proactively adjusting contracts to include changes such as new practice locations, updates in staff credentials, or new service offerings is vital. These adjustments help prevent future conflicts with insurance providers and ensure that reimbursement processes run smoothly. By maintaining current contracts, the practice avoids potential delays or denials in payment that could impact cash flow and overall operations.

Taking the time to review your contracts annually not only maintains your medical practice’s financial integrity but also ensures a stable and predictable reimbursement environment. Regular contract management is a proactive measure that aids the broader scope of medical practice management, reinforcing the stability and sustainability of your healthcare services.

Our founder, Erin Cammarata, offers specialty contract review and re-negotiation services to our favorite clients…If you know, you know. Feel free to ask about these special offers when you talk to your CBS Medical Billing Rep next.

6. Goal Setting for Medical Practices

Setting clear, measurable goals is not just a task; it’s a way to make sure your medical practice not only survives but thrives in the ever complex, increasingly competitive healthcare environment. We’ve created the “Four Pillars of Success” framework  to help maintain a balanced approach to growth and efficiency in medical practice management. Our clients around the country have implemented it to great effect. Here’s how you can effectively set and assess these goals:

• Patients: Goals related to patients might include improving patient satisfaction scores, reducing wait times, or increasing patient engagement through new services or outreach programs. Establish specific, quantifiable targets such as achieving a particular patient satisfaction score or a set percentage decrease in wait times by year-end.
• Referral Sources: For referral sources, aim to strengthen relationships with existing referrers and identify opportunities to build new ones. Set goals for the number of new referral partnerships you plan to establish and develop strategies for ongoing engagement with current partners.
• Your Team: Focus on enhancing team performance and satisfaction. Goals may include implementing regular training sessions, improving team communication, or introducing new employee wellness programs. Measure success by tracking turnover rates, employee satisfaction surveys, and productivity metrics.
• Reimbursement: In the realm of reimbursement, set clear targets for improving billing efficiency and reducing claim denials. Goals might include increasing the percentage of clean claims or shortening the revenue cycle timeline. Regularly review these metrics and adjust processes accordingly to meet these targets.

Continuous Assessment: To ensure that these goals lead to tangible results, you must regularly assess progress. This might involve quarterly reviews of achievement metrics, adjusting strategies in response to new scenarios, and celebrating successes to motivate the team. Don’t forget to enjoy the ride people! Otherwise, what’s all the hard work worth? 

Flexible and responsive goals are essential in the dynamic healthcare landscape, they ensure that your practice is adaptable and continue to progress no matter what changes come our way. These goal-setting practices will not only help streamline operations, but foster a proactive culture that’s geared toward continuous improvement and success.

FAQ: Best Practices for Medical Billing to Submit Claims and Collect Faster

1. Why is accurate patient information crucial for medical billing?

Accurate patient information is essential because incorrect details can lead to claim denials and payment delays. Medical billing services rely on precise data since insurance companies reject claims with errors, extending the billing process by weeks. To avoid this, verify patient details regularly, including name, date of birth, insurance ID, phone number, and address. Digital forms can streamline this process, allowing patients to update information before appointments. Using software like Weave Digital Forms ensures accuracy, reduces manual errors, and speeds up claim submissions.

2. How does verifying patient insurance eligibility help in medical billing?

Verifying insurance eligibility prevents claim denials by ensuring a patient’s coverage is active before treatment. Patients may change or lose insurance between visits without informing the healthcare provider. Medical billing companies emphasize the importance of checking eligibility for each visit to avoid billing incorrect insurance providers. This step differs from insurance verification, which confirms if a service is covered. Using tools like Weave Insurance Verification automates the process, saving time and ensuring claims are submitted correctly.

3. What are the common medical coding errors, and how can they be avoided?

The most common medical coding errors include undercoding (assigning less expensive codes) and upcoding (using more expensive codes), both of which can cause claim rejections. Other errors stem from vague provider documentation. To avoid these mistakes, always double-check medical codes, ensure patient details match coding data, avoid duplicate billing, and communicate with providers for clarity. Outsourcing medical billing to experienced professionals can help maintain coding accuracy, reduce payment delays, and ensure compliance with regulations.

4. How does submitting claims on time improve revenue flow?

Timely claim submission ensures quicker reimbursements and reduces the risk of missing deadlines. Many insurers require claims within 95 days of service; late submissions may result in denials. Developing a structured billing process—such as coding within 24 hours, submitting claims within a week, and daily claim reviews—helps maintain efficiency. Medical billing outsourcing can also help streamline claim submissions, ensuring no missed deadlines and ultimately improving cash flow while preventing revenue loss.

5. How can technology improve medical billing efficiency?

Technology automates many aspects of medical billing, reducing errors and speeding up collections. Revenue cycle management services integrate payment automation tools like Weave Payments, offering convenient options such as text-to-pay, short links, tap/swipe payments, and automated card-on-file transactions. These solutions help prevent late payments by making billing simpler for patients. Digital billing software also streamlines claim tracking, reducing administrative workload and enhancing medical billing services.

6. Why is monitoring payment trends important in medical billing?

Staying updated on payment trends ensures a smoother billing experience and improves collection rates. Current trends include digital payment methods, stored payment information, price transparency, and AI-driven payment processing. Patients expect a seamless, consumer-like experience when paying medical bills. Medical billing companies that adapt to these trends, such as implementing online payment solutions, increase efficiency and patient satisfaction, leading to faster collections.

Ready For The Best Year of Medical Practice Management Yet? 

As we’ve explored in this blog, implementing the CBS New Year’s Success Checklist can dramatically improve the management and operational efficiency of your medical practice. From enhancing your revenue cycle management with meticulous WIP reviews to ensuring rigorous compliance and effective training programs, each component of this checklist is designed to set your practice up for success.

CBS Success Checklist Recap:

• Revenue Cycle Management: Secure financial health with accurate billing and updates.
• Compliance: Stay ahead of regulations with thorough reviews and updates.
• Training: Boost efficiency and reduce errors with ongoing staff education.
• Accreditation: Ensure continuous compliance with regular manual reviews and scheduled standards.
• Contracts: Maintain up-to-date terms and adapt to changes within your practice.
• Goal Setting: Establish and regularly review strategic goals to keep your practice on track.

Remember, while this checklist is a powerful tool to guide your practice through a successful year, you don’t have to navigate these challenges alone. CBS Medical Billing & Consulting is here to support you every step of the way. Whether you need help implementing parts of this checklist or want to discuss custom solutions tailored to your specific needs, our team is ready and eager to assist.

Reach out to us today to ensure your practice not only meets but exceeds its goals in 2025. Let’s make it your best year yet! Contact CBS Medical Billing & Consulting to see how we can support your practice’s success. Visit our website or call us directly for a consultation.