Practice Management Alert

Well-trained billers may be your biggest assets toward improved collections.

With the decreases in patient visits and reimbursement that many practices are experiencing, capturing every dollar you can is essential. So now is the time to evaluate and focus on training your staff to be the best collectors they can be.

The problem: Collections can be very tedious and difficult, especially for someone who has never had experience dealing with patients or payers directly.

Collections training is very important, now more than ever, says Connie Treonze, practice administrator for Associated Orthopaedics in Union, N.J. The insurance companies [are] feverishly finding ways not to pay providers. If a staff member is not appealing and researching the denied claim, it will be a financial disaster for the practice.

Collections in general, and good training, are so important now because of the economy, agrees Marge McQuade, CMSCS, CMM, a consultant and director of education for PAHCS in Florida. The biggest thing is getting your staff to realize that they need to ask for copays before the patient leaves the office and that they may need to ask for unpaid balances and deductibles to be paid as well.

The solution: Arm your employees with the training they need to fulfill their collection duties so they will be better prepared when they speak with an unwilling payer.Use these expert tips to help every biller -- and non-biller -- in your practice become a collections pro.

Set Up Collections Training for New and Old

When a new employee starts in your practice, make sure you show her how to effectively capture payments from both patients and payers.

What our office does is to have the new employee sit with one of the collectors the first day, taking notes and observing our collections protocol, Treonze says. They are then moved into the actual collections process &supervised by one of my seasoned employees.

Dont forget current employees: You should have regular training to refresh the skills of your current employees as well, McQuade says. With collections being such an important part of a practices sustained success right now, you may even find youre tapping non-billing employees to help, so proper training is essential.

If staff is not trained properly, their effectiveness in collecting will be poor, Treonze stresses. Without supervision, they tend to do their own thing, which is usually the easy way out. The job is very frustrating, so monitoring is very important. It is very easy for a person to get burnt out dealing with insurance companies and patients.

Try Role-Play to Hone Skills

Tailor your training: You need to make the collections training process fit your offices needs,McQuade stresses. There are a lot of collections seminars and that kind of thing out there, but I dont necessarily know that that is the route to take, she says. You have to train your staff the way you want it done, based on the collections rules and what works in your office.

Conduct your training sessions in staff meetings or one-on-one with collection staff members, McQuade says. Choose whichever method and setting works best with your staff.

Role-play can be an effective training tool for new employees with no prior collections experience and for employees who may be nervous and unsure of themselves during collections attempts. Practicing sample scenarios also lets you gauge where your employees need practice.

Important: You should make sure that the scenarios you come up with are as realistic as possible. Use situations that your staff can identify with, which encourages participation and investment in the process.

Tip: Set up role-play scenarios that involve collecting from patients and collecting from insurance companies.

Both have unique challenges, but both are important components of bringing in the practices deserved reimbursement.

Bonus: Check out the sample role-play scenario on page 44 for an example you can use in your collections training.

Arm Your Collectors With Knowledge

Part of your collections process should be providing your employees with the documentation they need to effectively converse with patients or payers. First, they need to have the account information with exact numbers on what the patient or payer owes your practice. They also need to know if there have been any past efforts made to collect on the account. In addition, make sure your collection staff has documentation of your practices collection policies to refer to.

They need to have tools in order to be effective, Treonze says. Enroll them in coding forums, subscribe to correct coding companies that can give them the necessary CCI edits needed for appeals, and always have the current coding books for CPT, HCPCs, and ICD-9 at their disposal. They also need to look at past coding journals from the medical societies. These journals also give very useful tips.

Good practice: Make sure you also access the payers Web sites for their rules and specific guidelines in areas such as medical necessity, frequency, etc. Access to the third party payers remittance advice assists in patient collection calls as the information on what was paid and allowed by the payer is outlined on the remittance advice. Additionally, the patient responsibility is also listed on the third-party remittance advice and will assist you in the patient collection calls.

Helpful tools: Give your collections staff scripts and small written reminders to help them in their collections duties, McQuade says. In the past I have written out what I want the receptionist or whomever to say, she adds. In one office, I posted a note that said, How will you be paying for your copay today? by the receptionists desk because she kept forgetting to ask for the patients copay.

Monitor Collections Success Rates

The only way youll know if your collections training is working is to regularly evaluate how successful each collector is. Reviewing individual collection rates can also help you tailor your training so that youre helping your billing staff where they most need help.

The most valuable tip I could give anyone is to put in place a check and balance system for your billing/collections department, Treonze says. Without supervision and a hands-on approach, costly mistakes and errors can occur. Im not saying that you have to stand over and watch every minute of the day. You need to give your employees breathing room to make decisions so they know that they can take pride in their hard work, but monitoring is very important.

Follow up on accounts: Someone in the billing department should review collection efforts, preferably on a weekly basis. I monitor each one of my collectors with a weekly performance form that I have implemented, Treonze explains. Each collector needs to note the account numbers worked along with zero EOBs, etc. This is handed in at the end of the work week. This form allows me to see if they are actually working the account; and, more importantly, working it effectively.

Stay tuned: You may need to set up payment plans with patients in order to effectively collect from them. Watch for an article about setting up patient payment plans in the next issue of Medical Office Billing & Collections Alert.