A Look at the Average Day of a Medical Biller

May 28, 2013

Take a peek inside the diary of a medical biller to see what really happens each day at her desk. Chances are, the same thing is happening at your practice.

Dear Diary:

It’s Monday and first of the month (deep sigh). I reviewed patient accounts to see who needed a regular statement, who was past due, and who should go to collections. I really don’t like turning people over to collections, but sometimes there’s just nothing else to do. Sometimes, they force my hand. Mr. Jones told me last week when I called that he didn’t care if I did turn him over to collections, he was never coming back. Well, I guess not, I mean he already had the surgery and had a great outcome. He’s doing great ….why would he need to come back? Nothing like a threat made by a moot point to make me give you what you want. Ms. Smith told me last month that she didn’t pay her copay at her last visit because there were two other people in line behind her and she didn’t want them to see her debit card number. Mr. Jones called back today to say that if I did ruin his credit by sending him to collections that he would tell all his friends to never come here. I thought to myself….if your friends are anything like you, why would we want them here anyway?

Dear Diary:

It took me all day yesterday to review accounts because I kept getting interrupted with questions from the front desk like this: "Does Mr. Jackson have to pay his surgery deposit today?" "Do you know where the doctor is?" "We were checking benefits, and BCBS asked me for our tax ID, do you know what they’re talking about?" "Ms. Smith said you told her she didn’t have to pay her copay today….did you say that?"

I finally got statements printed and mailed out after lunch …well if you call it "lunch," it was actually scarfing down a sandwich while covering the phones so everybody else went out to eat, because "you’ve not really been busy this morning, so you won’t mind listening for the phones while we’re gone will you?"

Dear Diary:

This morning I checked the electronic claim status report to make sure yesterday’s claims were accepted only to find that Medicare has kicked every single claim out because of a name mismatch. After pulling up every Medicare patient in the batch, I found the problem! The periods after the middle initials! Can you believe that? The Medicare card didn’t have a period after the initial and kicked the claims out because we did. After fixing every patient in that batch, I had to find the report that shows patients by insurance company, print it, and fix every single Medicare patient. Do you know how many Medicare patients there are in a practice that deals with skin cancers?

They keep saying electronic fund transfer (EFT) is going to save me time …but I’m not convinced yet. I logged on to all the websites of insurance companies who send us EFTs and started to download and print the explanation of benefits (EOB). It shouldn’t have taken that long, except two of the websites kept kicking me out after each EOB was downloaded. I tried calling customer support and what a joke that was! Their answer was that they were experiencing some system issues. Um, you think?

Dear Diary:

Today I had high hopes of being very productive. I got to work early, printed out my accounts receivable (A/R) report and got off to a great start. At 9 a.m., I got an urgent call to the front desk, only to discover that it was Ms. Smith at the window demanding to know why we asked her to pay a copay when her insurance booklet clearly stated routine physicals didn’t have copays. Did I really have to come up there to explain to her that what we did was examine and biopsy a potentially cancerous lesion and that is not a routine physical? In response, she said, "Well he did listen to my heart and take my blood pressure, and besides he was only in the room for 15 minutes."

Dear Diary:

I can tell that statements have been received. By 10 a.m. I had already taken 10 calls from patients who were sure we had made a mistake on their bill and had messages to return 30 other patient calls. It took most of the day to answer all of those questions, because you know the ones who took the time to call didn’t have just one question …no, they wanted to go over every single line item on their bill! If I hear from one more person how screwed up they think our billing system is, I just might scream.

On top of that, a boatload of checks came in the mail, which in addition to the EFTs I was finally able to download, will make for a great deposit report today. But my joy was short lived when I saw that 2 percent sequestration cuts have started. I didn’t think it was going to happen for a few more months, but then again who can understand all the conflicting information out there about who will and won’t be affected by sequestration and to what degree?

Well Diary, at least its Friday …I should be refreshed just in time to start all over again on Monday!