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Medical billing performance
Written by Amy Lillard   
Article Index
Medical billing performance
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Billing gets more complicated daily, with new legislation, new regulations and more. The penalties for errors include loss of practice-sustaining revenue, but also can include civil or criminal prosecution.

Free Online Tool: Evaluate your Medical Practice's Billing Performance

So why are errors made? First, consider all the billing department must do. They are in charge of coding correctly, submitting claims to payers, collecting co-payments, managing accounts, and more. And they have to keep up to date on the constantly changing rules. The real reason for errors and problems with billing is a neglect for all the components of the process.

Effective staff, clear procedures, and consistent evaluation must combine for a high-performing billing department. For success in billing, and the key to your practice’s effectiveness as a healthcare provider and business model, the process is key.

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The Team

For successful billing, you need good tools, effective reporting methods, firm procedures, and staff with perspective.
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Staff who is charged with the intricacies of billing should make a commitment to understanding and complying with all steps. To do this effectively, the practice should have clear guidelines on what the billing process is, as well as each staff member’s responsibility.

In addition, staff must be devoted to continually updating their knowledge on billing regulations. Physicians and administrators must implement a formal or informal training program on a consistent basis. This training should also include efforts to improve on results from billing method assessment (discussed below). All staff, including the front desk to the doctors, should be kept aware of changes in procedure, as they are all involved at some point.

The Process

  • Each practice should have written methods for sending out bills, receiving payments, follow-up on non-responders, dealing with denials, and other billing issues that arise frequently in your practice. This written process should be clear on who is responsible for each component. It should insist that employees document everything, for compliance issues and for evaluation.
  • The ongoing process must be monitored and it must be consistent. Full responsibility is created when the team works together to improve and assess the status of the practice as a business.
  • Reports, weekly or bi-weekly, can be an effective way to track successful payments, delinquent payers and patients, denials, and all follow-up. These reports can also help to prioritize contacts and tasks.

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