Quick tips for better performance

Lucien W. Roberts, III, MHA, FACMPE

All too often, we focus on bigger projects to improve efficiency or lower costs.Smaller initiatives can impact your bottom line, too. Here are a few of my favorites.

Prior authorizations

Refer to facilities that do the prior authorizations for you. Every electronic authorization costs you more than $5, while manual authorizations take nearly thirteen dollars out of your pocket, each and every time.

Ensure your clinic note supports the prior authorization. Ensure supporting documentation like labs are included with the clinic note. Doing so avoids unnecessary back-and-forth (and costly) communication.

Optimize electronic authorization processes. As noted above, manual authorizations cost more than twice what electronic authorizations do.

Billing

Avoid undercoding. Don’t be afraid to bill level 4 visits.A 99204 is paid at close to 50% more than a 99203.A 99214 is paid about 40% more than a 99213.

Don’t be afraid to bill a 99205 or 99215 when warranted. A 99205 pays 32% more than a 99204 (and over 97% more than a 99203). A 99215 pays 40% more than a 99214 (and more than 97% of a 99213).

Collections

Automated appointment reminders are fine, but most fall short in letting patients know what they will owe when they show. Patients should know in advance what they are expected to pay at the time-of-service.

If you have a lot of patients who show up without their co-pay or balance due, ask for a credit card. Better yet, keep a credit card on file.

If that fails, try the ‘Stamp in the Pocketbook’ trick. Buy a couple of sheets of stamps for your check-in person to keep in their ‘personal’ drawer. If a patient shows up without payment, have your person print out a statement, put one of ‘their’ stamps on an envelope, and ask the patient to please pay when they get home. The subtle nature of someone at the practice sharing one of their ‘own’ stamps works when nothing else has.

Two statements are enough. No one other than healthcare providers send more than one statement, yet we in healthcare are fine with sending three or four statements. It is a waste of time and money.

Employee productivity

Invest in an additional monitor for your employees. A second monitor is one of the best productivity investments for your billing and scheduling teams.

Thank your employees. Employee recruitment and retention are costly matters for most practices, and constant employee turnover is costly and leads to all sorts of inefficiencies and dropped balls. Letting your employees know you care for them and appreciate what they do will save your practice thousands and thousands of dollars over time.

Lead by example. If you treat patients as appointments, your staff will follow your lead. It is up to you to connect the dots by caring for patients as patients.

Credentialing new doctors and APPs

In new provider agreements, include a clause that says the new provider cannot start until at least 180 days after they give you everything you need to get them credentialed. Bringing on a provider who did not complete their end of the credentialing in a timely manner costs you money. It also leads to all sorts of scheduling hell when a new provider is credentialed with some, but not all, payors.

If you do not have an in-house, detail-oriented credentialing specialist, outsource this function.

Health insurance

Have your insurance broker draft a letter explaining how using higher cost providers impacts your practice’s health insurance premiums. Cut and paste this letter into an e-mail that you send to your employees twice a year.Remind them that using in-network providers and lower cost testing centers/hospitals/ASCs will keep their premiums from rising as much the following year.

Lucien W. Roberts, III, MHA, FACMPE, is a retired practice administrator and veteran Physicians Practice contributor.