Practice Management Alert

Inability to respond to your physicians inquiries about the status of particular accounts may be caused by improper organization of the billing department. A department that fails to foster employee responsibility for monitoring and following all accounts can drive up your practices accounts receivable.
 
The same person needs to handle a claim from beginning to end, including data entry, payment posting, and making corrections. If you have someone come in and handle a part in the middle, no one has accountability, says Maria Sanders, CPC, CHCC, president of The Claims Manager Inc., a medical practice management company in Neptune, N.J.

 
Many offices organize billing by payer, which can cause problems for a number of reasons:

  Because physicians tend to focus on big accounts rather than the entire reimbursement picture, the biller has to be personally motivated to follow up on the other accounts. The little accounts add up and, suddenly, they are a big piece, says Pam Sharkey, CPC, CMM, administrator of Medibilling, a 23-physician practice that provides centralized billing for individual doctors and physician groups in Paramus, N.J.

  If an employee is absent, other staff may not know the authorization processes, local medical review policies, or claim correction procedures of the insurer the employee handles. Other staff may not assume the extra work, and claims may not be submitted on time.

  Patient inquires must be routed to the correct biller. Patients who have supplemental or secondary coverage must deal with two employees, leading to miscommunication.

  Physicians also have to discuss accounts with several billing department employees.

 
Sharkey recommends dividing accounts by physician. A biller who handles the entire billing process knows about any problems, including the patients name and account history, and can report on each accounts status to his or her assigned doctor. The physician knows whom to direct any questions or concerns to and can monitor the billers progress.
 
However, dont rely on the physician to monitor your staff doctors may concentrate on reaching a dollar amount each month and ignore accounts receivable. If an employee meets the physicians goal, he or she has no incentive to work any harder. You are ultimately responsible for making sure your employees track past-due and delinquent accounts. Specify that duty in their job descriptions.