A common complaint I hear from physicians is, "How am I supposed to implement that, I have only two employees?" If your practice is overwhelmed, there are a few things that you can do easily to improve your bottom line.
While it does take some extra effort to verify insurance, track denials, perform an integrated payment audit, implement and monitor performance goals, contact payers regarding timely payments, etc., implementing these guidelines is well worth the time.
1. Collect copayments, coinsurance, and deductibles. Many practices underestimate the importance of collecting these at the time of service. By collecting the copay while the patient is in the office, the practice not only eliminates the cost of billing the patient for this amount but also ensures that it is collected. The likelihood of collecting on any account is reduced once the patient leaves the office. Establish a policy that all patient responsibility amounts will be collected at the time of service. You may also want to provide incentives (e.g. gift certificate to a local restaurant, department store, etc.) for the person with the highest collection rate.
2. Use electronic billing. Practices should file claims electronically with every payer possible. A paper insurance claim typically takes about 45 days for reimbursement, where the average payment time for an electronic claim is less than 30 days. There is a reduction in processing costs (staff costs, postage, forms, envelopes, etc.) associated with electronic filing. Filing electronically also provides error reports and allows staff to work rejected claims sooner. While it may be impossible to file all of the practice's claims electronically, the practice should aim for at least 80-90 percent. If your current clearinghouse does not offer a good assortment of payers, find a clearinghouse that does.
3. Cross-train staff. An efficiently run practice should not be severely handicapped by a loss of one member of the staff. While the workload may increase and delays should be expected, the practice should be able to carry on with business as usual. However, the sudden exit of an employee typically causes chaos in the practice. "Only Suzy knew how to process the claims on this system." By cross-training your staff, you ensure that the necessary skills are available in your office. You can shift staff to a function where the workload is heaviest. In addition, cross training provides staff with a better understanding of the entire process. This allows staff to see why their job is important and how it impacts others in the office.
4. Use automatic remittance posting. Although the cost may appear to be high, the expense of having your employees post all of those payments from the remittance advices is even higher. Automatic remittance posting increases staff productivity by eliminating paper handling, filing, and copying, as well as eliminating data entry errors, thus reducing processing costs. Finally, consider what your employee can be doing instead of posting payments: following up with payers, working denials, filing appeals, etc.
5. Process patient statements regularly and make sure that they are patient friendly. Send patient statements out at least weekly to even out the amount of patient calls generated by the statements and the number of payments received. This allows staff to work more efficiently. It also reduces the time to payment as patients receive their bills shortly after their visit instead of 30 days later. Patient friendly statements are those that are easy to understand. If a patient does not understand it, they most likely will not pay it.
Reproduced by permission from The Coker Group, CokerConnection, (Roswell, GA: The Coker Group, 2003), Vol. 3, No. 11, November 2003 by The Coker Group.