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Home » Finance » Outsourcing

Physicians Practice. Vol. 15 No. 3
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Build a Stronger Bottom Line

By Joanne Tetrault | February 1, 2005

Billing Experts ...

Sharon Kletzky
Office Manager
Palm Beach Dermatology
Lake Worth, Fla.
13 physicians, 10 sites

Birdie Madeiras
Billing Manager
Martha's Vineyard Orthopedic
Surgery & Sports Medicine
West Tisbury, Mass.
Solo practice, 2 sites

Andrea Millaway
Director of Billing
Family Medicine Associates of Texas
Carrollton, Texas
9 physicians, 2 sites

Rocco Monto  MD
Principal
Martha's Vineyard Orthopedic
Surgery & Sports Medicine
West Tisbury, Mass.
Solo practice, 2 sites

Holly velez  RN
Practice Administrator
Island Coast Pediatrics
Ft. Myers, Fla.
8 physicians, 3 sites

Todd Welter
President
R.T. Welter & Associates
Denver, Colo.
Consulting firm specializing in reimbursement issues for medical practices


It should be no surprise that, when we asked physicians to tell us their top five practice headaches, dealing with payers and getting paid (not to mention the overwhelming amount of documentation tied to it) were among the most commonly mentioned.

Last year more than 20,000 of you visited the Billing and Collections section of our Web site, www.PhysiciansPractice.com, to look at articles, Q&As, to download tools and calculators, and to find vendors to help you collect and bill. And more than 250 of you asked billing questions of our Ask an Expert panel in 2004.

The bottom line? It's a major concern for physicians.

We asked a group of in-the-trenches experts — office managers, billing directors, a solo physician — to talk about what they do to keep denials at bay, days in A/R low, and cash flowing. Some of their ideas are outside the box (a computer-based "hotline" for physicians to ask questions of billers); some are tried-and-true (having written payment policies and using electronic billing). But they all serve as a reminder that stepping back periodically and evaluating the health of your billing operation is good preventive medicine for your practice.

Physicians Practice: What benchmarks or other measures do you use to track the success of your billing operation?

Millaway: We benchmark against median and best practices, the MGMA [Medical Group Management Association] standards. [These include] total days in A/R, aged trial balance over 120 days, gross collection rate, and adjusted collection rate. We also create a snapshot of data entry, what we've collected, how much A/R has been worked, and we present that to our head doctor every month.

Velez: We use practice management stats from a company called Practice Support Resources. What I really like about this is that they are region-specific and specialty-specific. We use those benchmarks to look at net collections and gross charges in comparison to other practices and our specialty. And our compliance manager looks at the bell curve for coding, overall percentages that the American Academy of Pediatrics recommended. 

Also, we've spent a lot of time educating providers and doing some extensive internal audits and bringing that feedback to the providers. This has really helped our facility get more in line with the norms ... MGMA benchmarks.

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