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Examine Your Medical Billing Process for Improvement

Examine Your Medical Billing Process for Improvement

I met with a medical practice owner yesterday who was looking for some help and feedback on her business. She says she believes they are "doing fine," but she senses there are areas that could be improved upon. This is a great first step in making some simple changes that can yield amazing results.

Back in 2008, when I first wrote "The Lifecycle of a Single Claim," I was feeling quite overwhelmed and wondered where I should start to fix my medical billing problems. By creating this document, it allowed me to break down what appeared to be such a huge task and challenge, to a much more manageable one. The concept is simple, really. Just write down every single step that a patient's medical claim travels through at your medical practice.

When I initially performed this task, I counted 60 different steps through our billing process. Sixty may sound like a lot, but when you write down each step and carefully look at each one — and your practice's policies and procedures for that step — you will be able to identify areas of improvement. Start with the first area that needs attention, modify your process, and move to the next step. This may take several months to a year to get everything squared away, depending on how easy it is to make changes at your practice. Some people have a harder time reaching out of their comfort zone, than others.

Here are four strategies to help you tackle this challenge:

1. Include staff.

The key to making this first step a success is to include your staff members in making these changes. Ask them how they might perform a task more efficiently and get them to become part of the solution, instead of part of the problem. You will move much more easily through this process.

2. Tackle one item at a time.

Think of it as a science experiment. It is very important to make one change at a time and then give it a few weeks to see what the results are.  You may end up with another task to manage, or it may result in several tasks being combined into just one step.

3. Give yourself a break.

As you move through this process of identifying areas of improvement, you may be wondering, "How the heck did I get in this mess?" Try to avoid this type of thinking, and instead look at this experience thinking, "Wow! Another area I can improve!" Your attitude is infectious and should spread through your team in a positive way.

4. Plan for the long haul.

Know this is a long-term project and plan accordingly. Areas that need improving will not be fixed overnight or even in a month. This change process should take several months if you're doing it right. By taking the time required, those big changes are introduced slowly, and by doing one at a time it's much less painful for staff to accept those changes.

Once you have managed your way through this journey, and are confident with it, know that this has become a living and breathing document. It should change as your practice grows and modifies its policies and procedures. Assign each section to the appropriate employee to manage and set some guidelines for updating. You want to make sure you or a supervisor is approving any updates and changes, and that they correlate with your overall company culture. Most importantly, have patience. This might be a little painful, but the results will surprise you, and make your practice much more manageable.

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