Urology Coding Alert

Hint: Look at workers’ records over a defined period of time.

Practice managers know that schedulers and billers are crucial team members for any medical practice. But how can managers make sure that their clinically adjacent staff are working in such a manner that maximizes the practice’s potential for reimbursement?

Read on for tips on how to effectively evaluate how much work your billers are managing.

Think About Monitoring Like an Audit

“When we’re looking at productivity, the first thing we need to identify is what actions do we want to track? What’s important in your practice? And what do you want to track to make sure billers are meeting that productivity?” said Jean R. Pryor, CPC, CPCO, CPB, CPMA, CRC, CPC-I, CIMC, in her session “Ways to Ensure Your Medical Billers Are Productive” at AAPC’s 2023 HEALTHCON.

Figuring out your process for evaluation is an important first step. Basically, you’re conducting an audit, and the same general principles apply: Define scope, standardize the ways you’re evaluating the tasks and roles, and apply the evaluation process systematically.

Pryor recommends breaking down billers’ responsibilities into individual tasks and activities, and then assigning each item a point or number of points, depending on the complexity of the task or the amount of time it typically takes. To evaluate schedulers, you may want to tweak your evaluation to incorporate patients’ experience, too, because the ways in which schedulers interact with patients can have outsize effects on your practice — if your schedulers are so “efficient” with their time that they come off as rude to patients, patients may look elsewhere for their medical care.

Get Creative, Organizationally, if You Have the Volume and Space

Big practices may have the space and pressure to get creative with where employees work. Pryor says that her organization decided to move the associates responsible for taking calls from individual offices into a centralized call center.

These patient access specialists “take the burden off the offices” so they don’t have to worry about taking phone calls and can focus on providing patient care, Pryor explains. The patient access specialists triage phone calls, scheduling appointments, or passing clinical questions onto clinicians as needed.

This reorganization included dedicated managers, team leads, a business analyst, and full-time auditors, who all work to facilitate and support getting patients on the books and to the door.

The full-time auditors listen to recorded conversations and evaluate and score the patient access specialists’ interactions with patients. The auditors have a spreadsheet of everything that they want the access specialists to do, or they should do. They audit each associate every month, and the associates get scored on how well they did with those phone calls, according to Pryor.

This evaluation can and should veer toward subjectivity, too. The auditors look at how appointments are scheduled — for example, via phone calls or patient portals — as well as how the patient access specialists interact with the patients. Auditors are checking objective aspects like verification of patient information, but they are also making sure the patient access specialists are kind and friendly.

Auditing patient access specialists can produce a trove of important data. If you’re looking at scheduling, you can find out whether patients are being scheduled for the correct type of visit, like an appointment for an acute need versus chronic conditions, or annual wellness visits. You can really get into the nitty-gritty details if you have information on how much time clinicians prefer to spend on each type of visit — auditors can see whether physician A’s wellness visits were portioned for 30 minutes and physician B’s for 20 minutes, per their respective wishes. If your patients are experiencing a long wait time, a close examination of these types of scheduling details can help you pinpoint problems (for example, physician A not realizing that they’re regularly scheduled to see three patients an hour instead of two) and point you toward solutions.

Call in Employees Who Need a Nudge

Measuring productivity over time allows some grace. If a worker has an off month, it’s a lot easier to be empathetic to the reality that workers are people with lives and responsibilities beyond the office. Of course, employers may be extra concerned that remote workers aren’t pulling their weight and look a little more closely at productivity.

“If a remote worker doesn’t meet productivity three months in a row, then they’re pulled back into the office. Obviously, we don’t wait until that third month and pull them back without them knowing ahead of time that there’s danger,” she says.

It’s important to evaluate workers by using the same metrics across roles or departments versus location. Some workers may thrive in remote roles, where they don’t have water cooler conversations or other social interactions as a constant distraction or temptation. Others may be too enmeshed by their responsibilities at home to manage their paid work effectively. Fortunately, performing an internal audit of each role and worker gives managers the information they need to monitor employees and facilitate targeted change when or where it’s needed.

Rachel Dorrell, MA, MS, CPC-A, Development Editor