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Meaningful Health Care Informatics Blog

Aug 25 2010   10:29PM GMT

Hidden secrets for improved efficiency in the Billing department



Posted by: RedaChouffani
Uncategorized

Similar to many other industries, the larger groups seem to have the answers and have automated every major workflow or process that had complex steps or unnecessary ones.  Similar to how some fast foods mastered the art of creates burgers in record times, it is important to seek to learn from other’s experiences.
In healthcare the same should apply.  Whenever considering new ways to reduce cost and increase efficiently, we should look to what some of the larger organizations are utilizing and how some of those technologies can be applied at the small to mid-size level.  What has been a surprising facilitator for this, is the continuous drop in technology costs. 

One particular area that has some interesting solutions surrounding it, and is spreading throughout some of the mid-size organizations and it is the shrinking of FTE billing staff. 
Traditionally, a practice would review the overall national or MGM reported Provider to billing staff ratio and use that to hire for the billing department.  However, that model can no longer be used an accurate representation of what really a physician will need in terms of staff.

In most cases a billing department will ideally spend a significant amount on specific tasks or job roles.  These tasks would range from Coding, billing, Workers Comp specialists, Medicare Specialists, Collections, Claim follow-up, or simply authorizations.  However, depending on the size of the practice, one person may be responsible for all the above.
But let’s for a second discuss what technologies are available out there that can facilitate and assist this billing team reduce their work load or help them become more efficient.

Implement a Document Management or use Electronic EOB: This would significantly reduce the amount of time it takes to retrieve an EOB to review denials or simply to re-file a previously rejected claim.  This also can be combined with an indexing solution the will facilitate searching within the documents.
Implement electronic remit and auto posting for all insurance payments which would eliminate the majority of the time needed to post manually an EOB.  This process requires a clearing house that supports 835 X12 formats Scan to deposit checks: With the high number of checks coming into the practice, having a staff member drive to the bank and wait in line may seem as it is a waste of resources.  With many banks offering remote scan and remote deposit an organization can now deposit their checks without even leaving their office.

LockBox: This is another useful service that can be provided by your financial institute.  In this service a practice can have all their patient payments (from their website, checks, credit cards, ..etc…)Insurance payments to be all automatically posted to the system electronically in batch mode.  Basically no staff will need to manually the charges from a Kiosk, or a bank deposit, credit card transactions one line at a time.  So, if you calculate the time it requires one staff member to enter one patient payment and multiply it by the total amount of checks you are receiving daily, you will notice that eliminating this manual process will have a tremendous impact on the bottom line.  The way this works is simple,  the bank of a Revenue cycle Management firm will supply you with a utility that will generate a lockbox file (several standards available and PMS vendor must be consulted to ensure compatibility with the software), once all the transactions are received or totaled, a file is generated and submitted to the EHR/PM system.  The system then processes the file and posts all the payments by attempting to match the payment to the patient using identifiers such as (patient address, name from checks, Credit cards or other means).

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