When Your Admin and Billing Departments Work Together

November 1, 2014

Combining forces to work as a team will increase your practice's chances of getting paid, and can actually decrease workload.

When a new financial policy is made at your practice, I bet you rarely hear "Let the billing department decide!" But you should seriously consider it. Those who do billing or work at billing companies are cheering right now and I think the rest of us are scratching our heads and asking "But, why?"

As a physician you see patients and treat them. It's why you went to medical school. You're really good at that part; but maybe not so good at the back end of practice operations. Oftentimes, policies are made in practices for behavioral reasons, but once the results of these well-intentioned policies trickle into the billing department, things can often go awry very quickly. The best intentions sometimes create more work.

Try this instead:

1. Call a meeting with your billing department or outsourced billing company representative.

2. Identify areas that hold your claims up and prevent them from being sent out clean.

3. Ask for feedback on how your practice can change a procedure in a way that will assist the billing department in their processes.

4. Update your policies and procedures to reflect the needed changes.

5. Train your staff.

Those five small steps can make all of the difference in the world - and change how quickly you are paid. Think about it, shouldn't the people doing the billing work, that know there are mistakes that can be prevented, be allowed to help rewrite office procedures? Here are some examples of what could be changed right now to make the greatest impact:

• When entering collected patient copays into your system, be sure that the front-office staff balances payments on a daily basis. This will prevent data-entry errors (i.e., $1,500.00 instead of $15.00). Double-check to make sure all payments were collected at time of service, and that all payments were entered at time of service. All of this work will prevent phone calls to the billing department when patients receive their statements. Believe me, the volume of calls will be reduced significantly.

• Do a statement review. Run your monthly billing statements, and before they are mailed, review the balances to see why the patient is getting a bill. No statement generation is the best goal to have, but realistically we know that's close to impossible. Did the insurance company process the claim differently than the benefit information that was provided to you? Did the front office neglect to post a payment, but has a receipt you can now post? Does your software have any flaws or bugs that might post payments into the wrong area, creating a patient balance? Find out why the statement is being generated. By doing this, the call volume will decrease significantly.

• Do you have a staffer checking claims denials? When a billing department asks the front office to provide additional information or call the patient and obtain the subscriber's date of birth, those types of requests should be top priority. The longer the front office waits to send that information over, the longer the billing office has to wait to send claims out. Aging out a claim due to missing or incorrect information is a poor way to run a billing department. You can also run into timely filing deadlines and then you'll never be paid.

• Does your front-office staff know what insurance plans you take? If you see a patient on an insurance plan you are not contracted with, even the best medical biller can only get you out-of-network payments. Be sure your front-office has a list of accepted insurances.

There has always been an "us" versus "them" divide between the front office and the billing department. That stigma needs to be tossed out today. Two groups of people with the same exact goal (getting the practice paid) should be working so close together, their hands should be intertwined. Take a moment and meet with your billing department, you won't regret it.