Running a successful medical practice requires more than just offering top-notch patient care. Effective management of billing and collections is crucial for maintaining financial health. Many practices partner with specialized billing and collection companies to handle these tasks, but fail to recognize that the relationship requires active management to truly unlock its full potential. In this post, we’ll explore how to effectively work with your billing and collection company, the importance of quarterly check in meetings, and how your healthcare legal team can be deployed where needed to ensure maximum revenue for your practice.
Understanding the Role of Billing & Collection Companies
Billing and collection companies specialize in handling the financial transactions of your practice. They manage claims processing, patient billing, and collections, ensuring that your practice gets paid for the services rendered. However, they aren’t always forthcoming about their own limitations. This makes it essential for you, as a practice owner, to take an active role in managing this relationship.
The Importance of Taking the Lead
One common challenge practices face is not knowing what they don’t know. Billing companies may not highlight their own shortcomings, so it’s up to you to lead the relationship to success by asking strategic questions that reveal opportunities for improvement. Here are key areas to focus on:
1. Regular Communication
Establish regular communication channels with your billing company. Schedule quarterly meetings to review performance, address issues, and set goals for the upcoming quarter. These meetings are an excellent opportunity to ask questions and get a clear picture of your financial health.
Questions to Ask During Quarterly Meetings:
- What are our current collection rates, and how do they compare to industry standards?
- How do our collection rates in each age bucket compare to the prior quarter?
- What are the top 3 denial reasons?
- How many zero pays do we have?
- How long is the average time from service rendered to payment received?
- Are there any emerging trends that we should be aware of, such as changes in insurance policies, coding procedures or regulatory requirements with respect to documentation?
- Are there any trends that you’ve observed that you think we need to evaluate to ensure compliance?
2. Performance Metrics
Understand and monitor key performance metrics. Knowing these metrics will help you gauge the effectiveness of your billing company and identify areas for improvement. Important metrics include:
- Days in Accounts Receivable (AR) – The average number of days it takes to collect payments.
- Net Collection Rate – The percentage of eligible payments collected.
- Denial Rate – The percentage of claims denied by payers.
3. Compliance and Legal Considerations
Work closely with your healthcare legal team to ensure compliance with healthcare regulations. Your legal team can help you understand where the billing company’s responsibilities end and where you need to step in. This can prevent potential legal issues and ensure that your practice operates within the bounds of the law.
Questions to Discuss with Your Legal Team:
- Are there any compliance issues we need to address?
- What steps can we take to reduce the risk of audits and penalties?
- How can we ensure that our patient billing practices are fair and transparent?
- Do I have any systemic payment issues that my legal team can assist with?
4. Continuous Improvement
Encourage a culture of continuous improvement within your practice and with your billing partner. Regularly review processes and look for ways to enhance efficiency and effectiveness. This can involve updating technology, training staff, or revising workflows.
5. Leveraging Technology
Investing in the right technology can significantly improve your billing and collections process. Many practices are investing in AI tools to assist physicians and staff with progress notes and charting, ensuring that progress notes support the codes being charged in each claim. Ensure that your practice management software integrates seamlessly with the billing company’s systems and that any direct payments made to your office are reported within both systems. This integration can streamline processes, reduce errors, and provide real-time data for better decision-making.
Conclusion
Effective billing and collections are vital for the financial health of your medical practice. By taking an active role in managing your relationship with your billing and collection company, scheduling regular check in meetings, and leveraging the expertise of your healthcare legal team, you can uncover opportunities for success and ensure that your practice thrives.
Ready to take your billing and collections to the next level? Schedule a consultation with our expert team today and discover how we can help you streamline your operations and maximize your revenue.
Credit: Sinead
