Apart from the patients, billing is the lifeline of the medical office. Whether your medical officeâ€™s billing is done in-house or youâ€™ve outsourced it to a medical billing company, there are specific things you should do that are crucial in maintaining a smooth billing process.
â€¢ Train the front desk staff. It is imperative that staff at the front desk has some type of introductory insurance and/or billing training. Make certain your staff is verifying insurance benefits prior to patientsâ€™ appointments. Be sure to train new employees on the various types of health insurance; indemnity plans, HMOs, PPOs, and POS plans. Educate the front desk on authorizations and referrals. Explain the difference between â€˜Original Medicareâ€™, â€˜Medicare Advantageâ€™, and â€˜Medigapâ€™ in order for the correct co-payment/co-insurance to be collected and the correct health insurance cards to be copied for billing purposes.
â€¢ A thoroughly completed patient registration form is crucial in the billing process. Nothing frustrates a medical biller more than a missing insuredâ€™s date of birth, a suffix missing from a Medicare HIC number, or a missing home phone number. Train your front desk staff to keep a watchful eye on the registration form to make certain all fields are completed! This tip not only helps with initial claims submission, but also assists in future collection procedures.
â€¢ A biller and only a biller! If your billing is done in-house, your billing should be designated to specific person/persons whose only job is billing. When the same person who is manning the front desk, putting patients in rooms, and answering all telephone calls is also the employee who is doing your billingâ€”mistakes are bound to happen. These mistakes may be the very reason a provider will make the decision to outsource the practiceâ€™s billing.
â€¢ Using a web-based application, such as Kareo, is especially helpful in improving billing productivity because it allows the provider and billing service to stay connected. For one thing, the medical office has access to patient accounts, which can be helpful in collecting outstanding patient balances during an encounter. On the other hand, the biller has real-time access to any patient demographics, diagnoses, insurance, or any other pertinent information needed to prepare claims for submission.
â€¢ Maintain your accounts receivable. Many a provider would be shocked if they knew the dollar amount in their 90+ column on their insurance aging report! Each state has prompt payment statutes which give the timeframe in which both paper and electronic claims are to be paid. If your billing is done in-house, take the time to ask your biller to print an A/R report. If you are unhappy with what you see, find out the exact problem. Is it that your biller does not have enough time to post charges, post payments, submit claims, and maintain the A/R by themselves? Are you the owner of a billing service whose billers are in charge of their own accounts for the entire life cycle of the claims? In either scenario, listen to your biller(s) and if they need help, hire a separate employee whose only job is maintaining the accounts receivable.
Michelle Rimmer is the owner of the Professional Medical Billers Association and ABA Therapy Billing Services.Â She has authored two textbooks: Medical Billing 101 and Coding Basics: Understanding Medical Collections and is currently working on her third textbook, which is due to be published in 2012. She also works with KareoÂ medical billing software to provide informative articles for Getting Paid.