How Do I Increase Private Practice Revenue Without Seeing More Patients?
- Feb 6
- 8 min read
With overhead increasing across the board for most private practices, constantly looming Medicare cuts, and insurance companies creating additional barriers for physicians to get paid for the work they do, most private practices are struggling to maintain income, let alone increase it. We often see physicians in our online communities for doctors wondering if private practice is worth it anymore. While on paper it does appear that physician salaries are increasing, many doctors point out that 1) they’re not keeping up with inflation, and 2) they’re working harder and harder for the money they earn - seeing more patients, working more hours, etc. That said, it’s important to remember that making more money is sometimes about working smarter, not harder. Most private practices would benefit from an audit of their systems, as optimizing things like revenue cycle management, ancillary income streams, scheduling, and payer mix would create more income - without seeing more patients. Below, we’ll cover the checklist we think every private practice should go through regularly to reclaim money they’re leaving on the table.
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Where do most private practices leave revenue on the table, and how can they increase revenue without seeing more patients?
At the end of the day, the equation for the majority of revenue a private practice makes is simple - it comes down to how many patients you see, how much you make from each visit on average, and what your collections rate is. Then you add in ancillary income you may have from things like product sales, real estate, and additional private practice income streams. Â
If you don’t want to increase how many patients that you see, you’re going to have to adjust the other levers to increase your overall private practice revenue. Below, we’ll cover the ways to do that.
Note that revenue is different than net income, which also factors in overhead. If you’re looking to decrease overhead, read our article on ways to decrease private practice overhead.
Make sure you’re actually collecting the money you bill for
As obvious as it sounds, this is where people leave the most money on the table. Optimizing revenue cycle management is essential to ensuring you get paid for what you do. This means:Â
Ensuring charges are submitted accurately to minimize denials
Collecting what you can from the patient at the time of service
Shortening the amount of time things sit in accounts receivable (A/R)
Keeping processes in place to make sure you follow up on A/R and denials in a timely way so that claims don’t move into a bucket where they’re no longer eligible for payment
Consider implementing AI to help in revenue cycle management
As a general rule of thumb, you want your collections rate to be greater than 95%. If you’re not sure that you’re there, you can get a free audit from one of our partners.
Related PSG Resource:
Our partner Cosentus​ has been highly reviewed by several physician clients and has helped several of our physician members' private practices with their credentialing, billing and coding, revenue cycle management, and accounts receivable services. Cosentus offers a dedicated team to manage the medical insurance verification process for you. As part of a perk for PSG members, they offer a free professional billing and coding review, as well as 5% off services through our affiliate link with the code PSG5OFF.
Make sure you’re not undercoding or not billing for work done
We are all (rightfully) fearful of overcoding. But sometimes this leads to actually undercoding, which is also not appropriate. Make sure that you understand billing and coding in your specialty well enough to know when you’re able to bill at higher levels for services rendered. A lot of physicians use lower E/M codes because they are fearful of audits, forget to add modifiers, or don’t bill for things that they are absolutely allowed to bill for like care coordination or prolonged services. Many underuse time based coding for longer visits, or downplay the complexity of medical decision making for certain visits.
Fortunately, many AI tools in the pipeline should be able to help determine levels of service more objectively, but in the meantime, if you don’t have access to these, ask your peers for best practices and standard of care.Â
Existing EMR tools and AI scribing services can help ensure that your documentation supports your level of billing. Make sure your templates are set up to include or emphasize the billable elements.
Similarly, if you’re able to bill for follow up phone calls you make during the day or after hours questions on call, don’t be shy about asking to get paid for your work. Again, there are AI services that can transcribe your calls to provide documentation of these services.
Related PSG Resource:
OpenEvidence is the leading AI-powered medical information platform for physicians, and also has several tools, including a scribing function that can be utilized in conjunction with a dialer function to call patients and create documentation for the encounter. It is free and unlimited for physicians. Sign up today through our affiliate link.
Add ancillary services to your practice that can serve the patient base that you already have in your office
Think about all the things that you tell patients to do, places you refer them, or products that you recommend to them. While not all of these things can be brought in house (and while you have to be mindful of any conflicts of interest or Stark law), there are many completely legitimate ways to add revenue to your practice while also offering convenience to your patients. Some examples, depending on your specialty and skillsets, might include:
Diagnostic testing such as lab testing or imaging services
In office procedures such as ear piercings or cosmetic procedures
Remote patient monitoring or chronic care management
Related healthcare professionals or services (optician, physical therapist, masseuse, therapists, counselors, etc)
Skincare products, medication sales, eyeglasses, or product sales
These are just a few. Read more about ancillary income streams for your practice.
Related PSG Resource:
Ulta Lab Tests helps physicians provide affordable and high-quality lab testing for their self-pay patients while improving revenue streams for their practice. Ulta Lab Tests offers access to 2,000+ tests and panels at wholesale prices, with testing available at over 2,100 patient service centers, through mobile phlebotomy, or via in-house specimen collection. As a perk to PSG members, they are giving away 50,000 free CMPs to offer your patients. Registration is free and there are no subscription fees or minimum orders, helping keep overhead costs low while providing added services to patients. Learn more and sign up through our PSG affiliate link. You can book a demo with the Ulta Lab Tests team to walk you through it or help you get set up through our partnership inquiry form.
Look at your payer mix and renegotiate bad contracts
The unfortunate truth about the business of medicine is that there is a lot of variability in how you get paid depending on who is paying for your patient’s care. While we all want to provide services to everyone, it’s important to make sure that your payer mix is sustainable. Every practice should regularly audit and reevaluate their payer mix to see if there are certain payers who aren’t paying in line with others, if certain payers regularly deny payments, or if it makes sense to offer as many visits for certain payer groups.Â
In doing so, it may be necessary to drop or renegotiate contracts with payers that are routinely underpaying or not paying. Learn more about negotiating insurance contracts.
It’s also possible to explore hybrid payment models where you accept insurance for certain procedures and do others as cash pay services.Â
Optimize your scheduling templates and reduce no-shows
The other thing that many physicians forget to do is to regularly reexamine their patient templates.Â
Make sure that you optimize your templates to allow for the things that generate revenue, such as procedures or cash pay or higher paying services.Â
If you often have no-shows, you need to address this. That’s time that you’re in the clinic and could be earning revenue but aren’t. Change your practice policies to discourage no shows, implement a patient reminder system that encourages them to let you know if they need to cancel, and charge deposits if you need to.Â
Think about where you could bundle services if it would allow you to get more done in a day.Â
Learn more about optimizing your patient scheduling template.
Recognize that you’re a business and optimize your operations
Don’t leave easy money on the table. Your business bank accounts, credit card accounts, unused office space, etc, are all opportunities to pick up a few extra dollars. Make sure that you get rewards and appropriate interest or income on these things. Similarly, if somebody is asking you for extra work such as forms, letters, administrative services, convenience or same day options, or other services not covered by insurance, depending on your practice model or environment, it may be appropriate to ask for additional money for places where additional practice resources or staff are utilized. When in doubt, make sure you discuss with a licensed healthcare attorney.
Learn more about renting your unused private practice office space.
Conclusion
Private practices notoriously leave money on the table. This is understandable, as most of us don’t think of our practices as businesses, but rather places where we offer our physician services. However, in order to be sustainable and get appropriately reimbursed for our time (which in the long run increases physician career longevity - necessary for everyone in this era of physician shortages!), it’s important to periodically take a step back and look at the practice from the 30,000 foot view. Think about how to optimize your revenue cycle management processes, your ancillary revenue streams, and your scheduling templates and office protocols, procedures, and policies. If you’re ever in doubt about whether you can or cannot do something, discuss with your revenue cycle management parter or an experienced healthcare attorney in your area to help you navigate the situation.
Related resources for physicians
Explore related PSG content & resources:
Our partner Cosentus​ has been highly reviewed by several physician clients and has helped several of our physician members' private practices with their credentialing, billing and coding, revenue cycle management, and accounts receivable services. Cosentus offers a dedicated team to manage the medical insurance verification process for you. As part of a perk for PSG members, they offer a free professional billing and coding review, as well as 5% off services through our affiliate link with the code PSG5OFF.