Do you wish you could perform an exam on your accounts receivable much like you perform an exam on your patients? Maybe you can with a few smart tips regarding your staff, management of insurance functions and savvy ideas for patient collections.

You may feel like you need to be a super hero to get everything done in your office; earning our tights gets harder every year with the many changes in healthcare. There are many facets of practice operations that can affect reimbursement. The first thing to address is the staff, front office and billing – are they qualified? It is important to hire qualified individuals and train them well to perform the specific functions that support best practices in revenue cycle management.

The staff members who affect the revenue are not usually compensated as well as clinical staff members. Consider a performance based incentive program to boost morale and buy in. You want these individuals to be passionate about the job.

If you don’t have written billing and collection policies, now is the time to write them. Your staff cannot independently make decisions on how to handle unresolved claims or unpaid balances so you must give them guidelines to function efficiently and consistently.

The following tips in regard to insurance claims can help you save time and get the money in the door quickly.

  1. Make sure insurance and demographic information is entered correctly at registration; you should be able to track this on your audit trails daily. Are you utilizing electronic eligibility functions with your practice management system? Consider the batch eligibility that automatically runs the day prior to scheduled patients arriving.
  2. Ensure that charges are entered timely, within 48 hours of service.
  3. Send claims daily, work audit trails daily and work all denials on remittances at the time of posting. Have all claims been accepted by the payer?
  4. Appeal denied claims, and restrict write offs that are not contractual in nature.
  5. Teach the coding guidelines to the billing staff so they can follow-up on claim efficiently, and make sure they know what services may be bundled or show second procedure discounts.
  6. Work credit balances each month to be sure you meet the 60 day deadline with insurance companies.

While insurance receivables are difficult to monitor, in this economy it is the patient A/R that is a growing concern. In the past, most of your revenue resulted from insurance companies, but due to the changes in many policies, a large share of the burden has shifted to the patient in the form of increased deductibles and co-pays. Try these tips for increasing patient payments:

  1. Utilize eligibility and estimation products to know what payment is due. Collect prior to or at the time of service, for deductibles and co-pays on visits, ancillary services and especially procedures or surgeries.
  2. Offer a variety of ways for patients to pay, such as having change for cash transactions, online payments through a portal and/or payment plans drafted against a credit card.
  3. Transfer the balance to a medical credit card such as Care Credit, getting your payment in a matter of days. Don’t be afraid to offer a discount for a lump sum payment.
  4. Train front desk and billing staff to be collectors. Don’t be afraid to ask for the money and have resources to collect it.

Finally, ensure that you have tapped every resource your practice management system and clearinghouse has available. Now that the insurance exchanges are open, it is imperative that patient information is updated at every encounter. There will be a massive amount of insurance policy changes. If you need help, Warren Averett is happy to assist