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A Poor Medical Billing Process Can Impact Patients


When your patients have a great experience with your staff, but a not-so-great one with your billing department, it's time to make some changes.

June of last year, we started reviewing every single statement prior to sending it out to the patient. We have pulled about 25 percent of those statements each month due to the patient payment and statement crossing in the mail; an incorrect patient cost-share implemented by the payer; coding or payment posting inconsistencies; or EHR issues. By pulling these statements, fixing any issues, and then re-running the statement, we have increased our customer satisfaction rate 10-fold. This was and still is the single greatest system that we implemented into our billing process.

(I wrote an article on this earlier this year: "Improve Your Medical Practice Billing Process in a Few Simple Steps.")

If you have all of your claims clean and on track, a majority of your payers typically will pay you within 30 days or less. There are always the outliers like liens or Workers Compensation or HMOs. But the majority is paid quickly. This gives you an excellent customer service opportunity to capture. By reviewing how a payer is processing claims, you are able to immediately update and modify your front-office collection behaviors. Why is this important? We have found that approximately 30 percent of our insurance verifications are incorrect. Yes, that high. It could be as subtle as the insurance representative stating a $30 copay instead of a $40 copay. It could also be that specific appointment types are subject to a deductible, and that information is not provided to you on the initial phone call.

(You can read more about this here, "Help Medical Practice Staff Navigate the Insurance Verification Maze.")

Regardless, once you are paid on a claim, and you know the patient is returning for more treatment, by reviewing how that payer paid versus how you collected in office is critical. Patient statements are generated from what payers do not cover. This includes misinformation provided to your staff. When the patient arrives back in your office, your staff are now armed with information on how the insurance company processed the claim, and can explain this to the patient, resulting in less patient balance looming on your A/R. Because let's face it, you know you do your very best to treat patients. Your staff is top-notch in providing information and care. The fallout between your office and customer service typically falls under the "billing umbrella." If you look up your Internet reviews, do you see things like, "Great clinic: clean, nice staff, billing sucked,"? It happens all of the time. Take this opportunity to fix that stigma of a poor billing-department experience.

Just a few simple changes in your systems can and will increase your customer service satisfaction. It really isn't going to take your staff more time, it's really swapping time with another task, like spending time on the phone with the patient explaining why they owe more money.

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