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Practice Management Alert

Be The Best You Can Be:

Compare yourself against this checklist of skills every billing manager should hone.

Published on Wed Aug 06, 2003

Being a great billing manager means wearing a lot of hats. To wear all those hats well, you must constantly work to develop the skills that make a good billing manager a great one.
 
Perhaps one of the biggest ongoing areas for development for any billing manager is coding expertise, according to Adrienne Rabinowitz, CPC, billing manager for Western Monmouth Orthopedic Associates in Freehold, NJ.  "As a CPC, I have taught ... my staff to sharpen their skills at overseeing the front office, so that we have an extremely high rate of clean claims," which of course translates into more money for the practice, Rabinowitz explains. "With the training, [staff] are highly skilled at doing telephone appeals, explaining situations to patients, and they do quite a few written appeals with a high success rate of additional payments."
 
Another important skill set to stay on top of is computer skills, Rabinowitz notes. The billing manager must be able to ensure that the computer system is set up with "good billing capabilities," and stays that way, she points out. Also, if a practice wants to purchase a system, it is a really good idea to have a  billing manager with enough computer savvy to be actively involved in the process of choosing one, she continues. And the only way you can do that effectively is by knowing your way around computerized billing.
 
A billing manager's exact role will, of course, depend on the needs of the practice. However, there are certain skills and activities that any billing manager should pay special attention to, such as weekly staff meetings and training sessions, says Catherine Brink, CMM, CPC, president of HealthCare Resource Management Inc. in Spring Lake, NJ. Check yourself against this list of skills and essential functions, offered by Joan Elfeld, CCP, president of Medical Practice Support Services, Inc. in Denver, Col.:

 

  • Organize and present monthly educational workshops where you bring in provider reps, discuss system issues, review payer and/or practice updates and implement new procedures.
     
  • Develop an internal collection procedure. (This should include billing procedures, adds Brink.)
     
  • Perform periodic chart audits to ensure that documentation supports billed charges.
     
  • Implement a process to review all denied charges, and appeal as appropriate.
     
  • Implement a tracking system for activity relating to appeals, collections, pending claims, administrative write-offs.
     
  • Generate management reports that provide the physician/owners with user-friendly, understandable and accurate financial information.
     
  • Implement a system to follow up all unprocessed charges in the greater-than-55-day category.
     
  • Review unprocessed charges before automatically rebilling them. Correct any demographic or coding issues at that time.
     
  • Determine the percent of payer mix as it pertains to active patients.
     
  • Generate reports to include number of new patients (monthly), number of patients and name of the referring physician for patients referred to the practice, and number of patients referred from the practice to other physicians.
     
  • Implement use of documents designated by each payer (e.g., Medicare's advance beneficiary notice [ABN], non-covered service forms, referral and/or authorization forms, etc.).
     
  • Reconcile accounts consistently.

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