The front desk staff is responsible for checking in patients, collecting copies, and verifying insurance coverage on behalf of the patients. Out of sight does not mean out of mind, and out of sight does not mean out of mind when it comes to the underlying issues. Medical billing companies rely heavily on their support back office medical billing and collections, so having a strong bench of talent within their back office division are even more important, notes coding and compliance strategist at one of the companies
There is a great deal of benefit to the practice when the back office takes these tasks seriously and they proceed more smoothly throughout the practice. Your bottom line will see an increase in revenue when that happens, and you should enjoy a rise in profits. Everyone at the practice will benefit from that because it’s a bonus for everyone.
Six Effective Strategies for Optimizing Your Back Office Medical Billing Staff for Billing and Collections
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Train Select employees to set up payment plans
When you have self-pay patients or patients with outstanding balances who are coming to the front desk, you will find that it is necessary to set up a payment plan for them. However, it is actually the back office medical billing staff that is responsible for making the actual arrangements. There is no doubt that it is crucial that these plans are consistent and fair for all patients. Having one or two people in your back office medical billing who are familiar with how plans are set up correctly is a necessity for your business. It is also important to train back office staff in order to lessen the pressure on front desk employees to make decisions about waiving payments or to let their emotions get in the way of these decisions.
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Reconcile encounter forms and bill claims daily
It is advisable to seek clarification from the provider of the services if there are questions regarding the services provided. Billers should be able to determine what modifiers are appropriate to use and when they should be used. The billing staff should be making sure that clean claims are being submitted by your billers. A claim that is clean gets paid the first time around and is able to withstand an audit if needed. Good documentation is also essential to ensure claims are accurately billed. Documentation should include pertinent diagnostic codes, ICD-10 codes, and CPT codes. Additionally, claims should be reviewed and verified for accuracy before submitting.
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Analysis Insurance denials and develop process to reduce them
It seems that modifiers have been misused in some circumstances. Does the denial of a claim have anything to do with medical necessity? Do you have outdated codes? You will be rewarded by higher and quicker payments if you make the effort to track the denials and see where you are making mistakes. Furthermore, in order to ensure that denied claims are corrected and filled in a timely manner, it is important to establish processes for correcting and refilling denied claims.
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Follow up account receivable daily
It is important that you go through the insurance aging reports and review any claims that have been submitted over 60 days ago. In some cases you may have to call the payer, however most claims are paid within 21 to 30 days after they are submitted, so you need to investigate further.
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Conduct patient Analyses regularly:
Every time there is a problem with patient flow, it costs the practice money, which is why time is money. Office managers or practice managers are responsible for analyzing patient flow for all services provided by the office, finding problems, and discovering ways to streamline the processes. As an example, you might perform a study on the flow of patients. The length of time it takes for a patient to complete the check-in process and be placed in an exam room is reported in this report. You will be able to track and streamline processes at the front desk by using this tool. The speed of check-in can improve patient satisfaction and prevent providers from falling behind schedule as a result of a shorter check-in process.
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Designate one person to follow-up on patient balances
The front office of your practice is making sure that the patients are aware of their balances. It is essential that someone is assigned to ring the patients and ask them for payments in the back office. It is common for practices to outsource this aspect of their practice. In terms of continuity and regularity, it’s less important who makes the calls so long as follow-ups are conducted on an ongoing basis and on a regular basis.
