To operate your billing department effectively and efficiently, you need to recognize that billing and collections require good management. Following are some techniques that can improve your billing efficiency and help you get paid.
1. Establish expectations with your patients, your payers, and your staff. A common problem practices face is getting patients to pay their bills, deductibles or copays. Although nearly every practice has a financial policy covering when payment is due and how it can be paid, patients often don’t know about it. You have to have a written financial policy that is given to all patients when they register as new patients, stating what you’re going to do about time-of-service payments, how you handle collection later, whether you have any rebilling fees, and anything else you want to establish up front.
Expectations also need to be set for your billing and collections staff. This can be done by adopting policies and procedures regarding how your practice will handle past-due accounts, including addressing questions such as when patients should be called about their past-due accounts and when to send an account to a collection agency. Failing to define follow-up protocols means that work may never be done and renders the financial policy meaningless.
Practices should also strive to set expectations with payers. Just because an insurance company sends you a contract, that doesn’t mean there’s nothing you can do about it, and you have to accept all their terms. Maybe you cannot change the fee schedule, but what you can do, for example, is, if the insurance company has a 45-day timely-filing provision, you can say you want that to be 60 days. Be prompt; develop a system.
2. Establish accountability among your billing staff. Organize your billing department by payer, because every payer is different, and there are different rules and regulations for each. If you have someone who really understands Medicare, for example, that person should submit the claim, look at the claim reports, review the remittance edits, work the rejections, and do any follow up work.
3. Avoid batching work. Organizing work in batches may delay work and create bottlenecks. People don’t realize how much time they spend organizing the work versus doing it. We gather the charge tickets on a desk or gather referral forms to be typed into the system, but we’re not doing the work.
For example, a practice has some problems with claims with a particular insurance company. Every time the problems occur, they are recorded in a log in the hope that someone will eventually discuss them with the payer. If you focused on the problems, instead of writing in the log, the problems might get addressed. To focus on the problems, the practices need to look at the processes in which they occur and decide how to improve them. Review all the practice’s superbills to make sure diagnoses are linked to the codes and check for coding errors. If there’s a problem, the bill is to be sent back to the physician to make sure the diagnosis is accurate for the visit and treatment rendered.
Try to keep the work moving day by day. For example, everyone knows that you’re working on Monday’s data entry on Friday. And then it’s done and out the door. There may be some stragglers that doctors have to review, but now the work is moving every day instead of sitting. Claims now should take four days from the date of service to get billed. This system can be done in any office. The goal is to process a day’s claims in one day.
4. Acknowledge the billing staff members and make them a part of the practice team. Putting photographs of the billing staff in the reception area can help patients better identify with the people who handle the bills. It can also make the billing department feel as if it is part of the practice, rather than stuck in the “back office.”
Communication is the key to teamwork. The business office and front-desk staff should meet often so each unit can discuss what it needs from the other to make patient registration and billing easier. The practice’s senior physician should visit the business office often, making a point to acknowledge work well done and, also, routinely write notes to staff members inquiring about the status of claims and problems. We know that nobody can do his or her job without the others. If one person doesn’t do his or her part, it can kink up the whole system. TAC
Dr. Eric S. Kaplan, is CEO of Multidisciplinary Business Applications, Inc. (MBA), a comprehensive coaching firm with a successful, documented history of creating profitable multidisciplinary practices nationwide. For more information, call (561) 626-3004.