Practice Management Alert

To operate your billing department effectively and efficiently, you need to recognize that billing and collections require good management, says Elizabeth W. Woodcock, MBA, FACMPE, the director of knowledge management for Physician Practice Inc., a practice-management solutions company based in Glen Burnie, Md. Applying management techniques to your billing and collections process can help your practice avoid common problems that result in reduced revenue. Among the techniques that can improve your billing efficiency and help you get paid are the following:
 
1. Establish expectations. Expectations need to be set with your patients, your payers, and your staff, Woodcock says. For example, a common problem practices face is getting patients to pay their bills, deductibles or copays. Although nearly every practice has a financial policy covering when payment is due and how it can be paid, patients often don't know about it. "If we have a financial policy in our heads but we don't ever communicate it to patients, why would our patients follow it?" she says. "You have to have a financial policy that is given to all patients when they register as new patients. It should state what you're going to do about time-of-service payments, how you handle collection later, whether you have any rebilling fees, and anything else you want to establish up front."
 
Expectations also need to be set for your billing and collections staff. This can be done by adopting policies and procedures regarding how your practice will handle past-due accounts, including addressing questions such as when patients should be called about their past-due accounts and when to send an account to a collection agency. "If a practice makes patient calls and tells them to call back in 14 days or their accounts will be sent to a collection agency, and then doesn't do anything and doesn't look at that account for a year, how can it ever send the account to a collection agency?" she asks. Failing to define follow-up protocols means that work may never be done and renders the financial policy meaningless.
Set Expectations in Payer Negotiations
Practices should also strive to set expectations with payers, Woodcock says. "Practices think that if an insurance company sends them a contract, there's nothing they can do about it, and they have to accept everything the company says. Maybe you cannot change the fee schedule, but what you can do, for example, is if the insurance company has a 45-day timely-filing provision, you can say you want that to be 60 days," she says. "You should try to define the expectations, or at least make an equal playing field. Look at what your billing office protocols are and go back to the insurance company and say you need [...]