It can be very gratifying at the end of the day to check the amount that you billed and see that you had a very productive day. However, just as gratifying as this is, it is doubly annoying when the money does not actually come in. Why would the money not come in? There are a number of reasons:
1. Your staff did not get the correct information from the patient when he or she was seen. Maybe they entered the wrong date of birth or spelled the name wrong.
2. Maybe the insurance that the patient presented was no longer valid and your staff did not verify it.
3. Maybe the patient presented an insurance card from Medicaid or Medicare and failed to mention that he or she actually had a private insurance which was primary.
4. Or maybe you billed for a disallowed service (e.g. – a preventative physical examination when the patient, in fact, had one already this year).
Whatever the reason, when the money is billed but not received, your accounts receivables go up. So how do we combat this in our office?
1. Obviously the best solution is prevention. This means having a system in place to ensure that your front office staff are collecting the correct information. This will be the subject of a future post.
2. We have one specific employee is in charge of collections. This is her sole responsibility. She may have others who assist her, but she is in charge. She is not expected to answer the phone or file or anything else. Thus she can concentrate all her efforts on the collections. Finally, with one employee in charge we know who to approach when we encounter a billing problem or notice that the A/R is increasing.
3. We send our billing manager to periodic courses on billing, collections, and dealing with patients. With all the changing regulations by the government, as well as private insurance companies, this is the only way you can be assured that you are in compliance. When you do send him or her, make sure that you hold him or her accountable for collecting the information and then bringing it back, debriefing you and implementing the changes.
3. We hold periodic collections meetings – In our practice the partners meet with the collections staff monthly to ensure that there are no issues coming up. The importance of these meetings cannot be overemphasized. First can you show your staff that you are staying on top of collections and that when you expect tasks to be completed when they are assigned. Second, you can find out about problems before they become overwhelming. Often staff may not want to “bother” you with an issue and you may not know about it until tens of thousands of dollars are lost.
4. We ensure follow-up – I cannot tell you the number of times, when we first bought my practice, that we assigned a task to a staff member. We thought that it was being done, only to find out months later that in fact, they had stopped doing it. We came to realize that we can never assume a task is being done. We must always follow-up and ensure that it is being done.
4. We are not be afraid of requesting an in-person meeting with your representative from an insurance company. We discussed the importance of this in our E-book, “How to Double (or Maybe Even Triple) Your Income as a Primary Care Physician.”
5. We make sure we are using our billing software to its fullest. When you do, you can answer the following questions:
-Are you ensuring that all bills go out the same day as the patient visits?
-Are there features that will verify that the information in each claim is correct?
-Are you using all of the reports that your computer software has? This can help you discover if there is one specific insurance company that owes you a lot or one type of encounter that is not being paid. You can even found out if you are charging an appropriate amount for a given encounter.
These are just some of the ways that we keep our collections system running smoothly. What are some of the ways you run collections in your office?
