Speaker 1: The title of this video, How to Improve Your Medical Billing Processes, is something that's pretty much always a top of mind for most physicians and medical practice managers. Of course, they're usually preceded by questions like, why is my accounts receivable so high? Or, why does my revenue cycle department get so many claims denials? Over these next few minutes, we'll help to answer those questions, and we'll also quickly explore some key strategies and best practices to enhance your medical billing processes and to optimize your healthcare practice's revenue management. So now that you know what we're going to cover here, be sure to check out the description below this video, where you'll find some helpful links and more that'll help to further your understanding. And with that said, let's get into it. If you think about your own billing department, do you think it's operating at peak efficiency? Is it bringing in as much cash as you think it should? The first important thing is knowing how to recognize when you've got a problem. Some danger signs to look for might include things like, your accounts receivable are going up, but you're not seeing more patients or performing more procedures. You last implemented a rate increase quite some time ago. Or a significant percentage of your AR is in the over 120 days bucket, and a declining percentage of your AR is new, defined as 0 to 30 days old. And there are others that we'll get into later. But the good news is that modern billing and accounts receivable systems can streamline necessary processes enormously. So let's peel away the layers and get into what these processes are, and why they're so important. A first important step for medical practices is to acquire as much patient data as possible before the patient arrives. Some modern patient appointment applications can prompt registration staff to get demographic and financial coverage information at the front end of the process. And some systems even allow new patients to make appointments and submit insurance information at the time of making that appointment. And with new regulations, like the no surprise billing law that requires health care providers to give a good faith estimate to patients with no insurance coverage, having a robust system for making appointments and capturing insurance information up front is more important than ever. And then there are the patient forms, authorizations for third-party billing, and consent for treatment signatures that need to be collected. And historically, that would be done upon arrival at the initial visit. But now it's becoming routine for practices to mail or even email these documents in advance. And modern billing and accounts receivable, or EHR systems, also offer kiosks located in the waiting room. There, the patient can update their insurance and other information using the kiosk. And they can also do these updates using the patient portal of the EHR system. When it comes to charge capture and medical coding, modern systems, especially integrated EHR and billing systems, enable the implementation of a very efficient billing process. EHR systems typically help the health care provider to improve medical record documentation. Many systems offer support within the application to identify the correct procedure code for services provided. And avoiding medical coding errors means minimizing denied claims and improving cash flow. Another revolutionary area in medical billing is the claims processing and submission. Almost all insurance providers accept and encourage electronic submission of claims via one of the many clearinghouses. And Medicare requires participating providers to submit claims electronically if they submit more than 100 claims per year. Electronic submission can result in more timely payments and fewer denied claims. Now that the claims are out the door, let's get back to expanding on those danger signs we spoke about earlier, things that indicate trouble is brewing with your AR. One sure indicator is if your staff is bringing you an unusually high number of accounts for write-offs or referrals to collection agencies, especially of patients you've routinely seen. And another is if your days in AR, the average time it takes to collect on your accounts, is over 60 days. This is a figure that your office or billing manager should be routinely calculating and reporting to you. And then there's the amount of staff you're using for billing and collections. Does it exceed the average for your specialty? For instance, internal medicine or family practice requires relatively more employees for all billing and collection activities as compared to a general surgery practice. Whether you're seeing any of those danger signs or not, it's always a good idea to give your office a billing checkup to uncover problems and to ensure best practices. Questions to ask include, does someone update your insurance payment rates in the Billing and Accounts Receivable System contract file so that payments from insurance companies can be verified against the contract rate or the contract fee schedule? Does your staff follow up timely on unpaid or underpaid claims? Do they dispute rejected claims? Many insurance company contracts require that you submit claims within 30 to 45 days from the date of service. If your original claim is not received, you can get denials for untimely filing and lose out on revenue. Does your staff follow up on past due claims each month? Do they document this in your billing system? Many modern billing systems allow for a virtually paperless billing office. Does your staff track your appointments and visits to make sure medical records documentation, billing and coding are completed and all accounted for? Do they use your scheduling software to do this? Because if not, you may not be billing for each patient you see. Is your fee schedule consistent for all types of patients? Some practices only charge Medicare patients the Medicare allowable amount, but Medicare pays its allowable amount or the amount you bill, whichever is lower. If your staff doesn't keep the fee schedule updated, you may be losing dollars. Does your staff collect copayments at the time of visit? Copayments may be 10 to 25 percent of what you can expect to collect for an office visit. Is your staff sending payment reminders to patients with outstanding balances? Do they inform you of patient files where patient payments are seriously delinquent? Then there's a few reports you should be asking for and receiving each month. We spoke earlier about the Days in AR report. A couple others include an AR aging report that shows the amounts of your AR by aging bucket. The vast majority of your unpaid accounts should be less than 60 days old. And a revenue report that tracks the amount you've billed and collected each month and the amounts being adjusted off as well. As you think about your billing department, keep in mind a few core principles for management and organization. You should always be on the lookout for best practices. Challenge your staff to implement them and reward them when they make improvements. Remember, recognition for a job well done is almost as good as cash most of the time. Build accountability by monitoring performance. Your staff will respond to the things that you consider important, especially if you are consistent in asking for them. Pay special attention to risk areas such as patient payment plans and financial hardship waivers. Track denials and problematic collections. Limit the opportunity for fraud and embezzlement. Many physicians are victims of embezzlement by employees they trusted implicitly. Dividing up the duties of banking funds and posting payments is important. And there are ways to do it even in a small office. Make sure you're getting reports that show the deposits match the amount of the payments actually received and posted on the patient accounts. Finally, make sure you have policies and procedures for the business's billing process. Policies can guide existing employees and are vital to training new staff members thoroughly. Remember to check out the description below this video for helpful links and more. In the meantime, give us a call, drop us an email, or come visit us on the web. And don't forget to subscribe to our channel to keep up to date on the business of healthcare. The Fox Group, serving the healthcare community since 1989.