Make Sure Your Billers Watch Your AR – Not the Clock

The choice to outsource your medical billing can yield substantially better results than the choice to keep billing in-house. Why? Because a properly structured outsourced billing relationship insures that the medical billing company succeeds by making you succeed.

Almost all medical billing companies are paid a percentage of what they collect. This means they are only paid when you are paid. It also means the more they collect for your practice, the more they are paid. Internal medical billers, on the other hand, are almost always hourly employees. They are paid based on showing up in your office, not based upon how well they perform your medical billing or how much money they collect for your practice. This is not an alignment of incentives.

Most people would prefer all their service providers to have “skin in the game” and only be paid for success versus just for making an attempt. For instance, would you prefer to pay your mechanic only if he properly fixed your car (and only for a previously agreed to price) or would you prefer to pay him an hourly rate and hope he will be as effective and efficient as possible in performing the job?

In a recent meeting with a multi-physician provider practice I was told a tale that I have heard many times before. One of the offices multiple medical billers was out for a few days. While she was out her supervisor was looking through the billers desk for some information that was needed. What she found was over $40,000 worth of old claims that the biller had stuck in her bottom drawer and never billed. As if this was not bad enough, almost all of the claims were beyond the timely filing deadlines and the money was lost forever. When the medical biller was back in the office she was reprimanded for this horrendous error. She was not terminated – she kept her job despite the fact the office lost thousands of dollars because of this horrific medical billing performance.

When I asked the doctor why a more severe action was not taken, he explained to me that “we already have staffing problems and did not want to alienate the billing staff any further.” The guilty biller was apparently moved to the front-desk role and is now responsible for gathering demographic information and money.

There should be safety nets in place to catch $40,000 in missing claims. So how could this have gone unnoticed until a desk excavation? The office did not track and reconcile charges, payments or write-offs. The doctors had been told that the practice’s system could not report at this level. The system, however, indeed had the capability to do this, but the billing staff did not know how to properly use it. Without the the fully aligned incentives of a medical billing company, the investment is often not made to full utilize the capabilities of a practice’s medical billing system. $40,000 in missing charges is likely only the tip of the ice berg for this medical practice.

Utilizing a medical billing service that meets the following criteria can help you avoid a medical billing horror story like the one above:

- All the charges, payments and write-offs should be made visible to you. Everything should be tracked so no charges (batches, days or places of service, etc) can be missed.

- Your medical billing company should reimburse your practice for what you would have been paid by the payers based on your allowable for any claims that go past timely filing for reasons within the medical billing company’s control. What this means is that you never suffer financially if the billing company drops the ball. Try to have your billers reimburse you if they drop the ball.

- 24/7 access to the medical billing system so that full transparency exists between the practice and the medical billing company.

As physicians struggle with stagnant (at best) reimbursements and escalating costs, it is critical that they make the best possible decision in regards to their medical billing. Selecting a solution that structurally minimizes the risk of poor medical billing is critical.

No – your staff will not work harder for you just because you employ them; and No – the biller who lost you $40,000 will not do any better job collecting money and gathering information from patients. You will probably need to “sternly” reprimand them again.

Selecting a world-class medical billing service that provides total visibility into their process and has incentives that are fully aligned with those of the practice is the most reliable road to outstanding medical billing and financial excellence.

Copyright 2008 by Carl Mays II

The Lastest posts in Business

Pet Adoption from Rescue Groups
Rescue groups or organizations are volunteer groups dedicated to pet adoption. T...
http://www.bizarticlezone.com/business/pet-adoption-from-rescue-groups-5008/

Reply to the letter the Department of Public Information said nothing about the tariff application of specific pricing
Industry and the Ministry of Information Industry in Beijing yesterday, put forw...
http://www.bizarticlezone.com/business/reply-to-the-letter-the-department-of-public-information-said-nothing-about-the-tariff-application-of-specific-pricing-5006/

Top Suggestions For Choosing Hen Night Outfits
A bachelor party, hen party, or hen night is a party staged for a woman who is s...
http://www.bizarticlezone.com/business/top-suggestions-for-choosing-hen-night-outfits-5004/

Suggestions For Choosing Hen Night Outfits
A bachelor party, hen party, or hen night is a party staged for a female who is ...
http://www.bizarticlezone.com/business/suggestions-for-choosing-hen-night-outfits-5003/

Refinancing home loan
Co-submitted by: Shanghai World Expo will supply almost a 1000 flats of new power automobiles
April 20, Shanghai Electric, Shanghai Automotive Industry (Group) Company said h...
http://www.bizarticlezone.com/business/shanghai-world-expo-will-supply-almost-a-1000-flats-of-new-power-automobiles-4999/

Shanghai World Expo will deliver virtually a thousand cubicles of novel energy automobiles
April 20, Shanghai Electric, Shanghai Automotive Industry (Group) Company said h...
http://www.bizarticlezone.com/business/shanghai-world-expo-will-deliver-virtually-a-thousand-cubicles-of-novel-energy-automobiles-4998/

France hopes to participate in China's large plane project
The first visit to China since 1982 the French National Assembly Bernard said fr...
http://www.bizarticlezone.com/business/france-hopes-to-participate-in-chinas-large-plane-project-2-4996/

How Internet Marketers Should Use Social Networking Sites
Social media in the form of social networking and online social bookmarking are ...
http://www.bizarticlezone.com/business/how-internet-marketers-should-use-social-networking-sites-4995/

France hopes to participate in China's large plane project
The first visit to China since 1982 the French National Assembly Bernard said re...
http://www.bizarticlezone.com/business/france-hopes-to-participate-in-chinas-large-plane-project-4989/