Boosting Collections at Your Medical Practice: Whose Job Is It?

January 28, 2012

Embrace the relationship between your billing company and your medical practice staff.

Whether you have just transitioned to a new billing company or you've had yours for years, making the most of that relationship is what will get you paid on your claims.

As soon as possible, meet with your billing company and set some expectations for them, and ask them to do the same for you. Here are some very reasonable requests from both sides of the relationship:

Billing Company Expectations:
• Postings to patient account within five days of receipt of deposit log
• Claims billed out within five days of patient visits
• Requests for missing information requested by insurance company provided on a weekly basis
• Monthly dashboard reports which includes: Closing AR, inflow, charges, adjustments, payments by insurance class, individual physician - visits, inflow, and charges.
• Any industry information updates that might adversely affect your A/R

Physician Office Expectations:
• Data sent to billing company has been double-checked for accuracy (spelling of name, DOB, address, insurance policy number, etc.)
• Requested information that has resulted in denial or delay is sent back within five days to billing company - data sent is what was requested (copy of authorization, ID Card, RX, notes, etc.)
• Weekly deposit log sent along with all EOBs
• Copay, co-insurance, and deductibles are collected up front from the patient
• All necessary authorizations are obtained correctly

If you have struggled in the past with your billing company, and you are not performing the tasks listed above, that could very well be part of the reason. You now need to shift your thought process (as well as your staff’s) to seeing your billing company as a partner in your business. Too often I hear, “Well THEY aren't doing it right!” The billing company can only do so much with half of, missing, or incorrect information. By being proactive up front and extending that olive branch, you are opening a communication pathway that can only result in getting your claims paid!

Something else I strongly encourage is to pick a staff member to be the point of contact for your billing company. If they pick one person and you pick one person, you've cut the opportunity for miscommunication ten-fold. In a lot of cases, you will end up having staff members all doing the same task (i.e., gathering information, double-checking entry, etc.) so be clear with who is doing what. You've already increased your inflow by a matter of decreasing human error, as well as assigning tasks to staff.

By having this point of contact person in place, they will form a relationship with the contact at your billing company. It is very important that they trust each other and work hard to develop that trust. You will be able to identify areas of strength and areas of opportunity much quicker when everyone is on the same page. By being involved, it shows your billing company that you care about your patient accounts. The more you care, the more they will care. That's what you ultimately want: for them to care. I do not recommend micro-managing them, but your point of contact certainly can go into the unpaid patient accounts and lend a hand in answering questions, and provide any missing information. Oftentimes, the patient comes with a story or a reason why x, y, and z happened. The more this can be communicated to the billing company, the more likely they will be able to work with the patient to resolve their billing issue.

How many days is your A/R ?– Next week, we will discuss the reports you need to run daily, weekly and monthly, to make sure you are maximizing your inflow opportunity.

Find out more about P.J. Cloud-Moulds and our other Practice Notes bloggers.