Practice Management Alert

If your practice's billing department isn't as efficient in handling claims or as effective in producing revenue as you'd like it to be, it may be time to examine the entire billing and collection process. The key to improving your billing and collection operation is first recognizing when you have a problem, says Elizabeth W. Woodcock, MBA, FACMPE, an Atlanta-based consultant for the Medical Group Management Association (MGMA) Health Care Consulting Group in Englewood, Colo. Although it's true that every practice's billing department is different, the best-performing departments manage the entire process of billing and collection well, she says.
 
"There's no magical answer for how to do billing better. But, the best billing departments have good management of the process from beginning to end," she adds.
 
An MGMA annual study of medical group performance and successful management techniques released last year also found that medical groups with good financial results have addressed or avoided some common mistakes, Woodcock says. Among the top mistakes are the following:
 
1. Ignoring the process and focusing only on the office. Billing is more than generating claims and collecting revenue, Woodcock says. It's a process that begins when the patient arrives at the reception desk and ends when payment is received. "Many practices have the perception that the billing office is a handful of people who sit in some back corner typing away at claims. But, they can't do their job without the physician doing the coding, the administration negotiating the contract with insurers, the front desk updating patient information, and every other person in the practice gathering information correctly," she says.
 
Focusing on billing and collection as a process has been the key to managing accounts receivable at The Physicians Clinic of Spokane, a 20-doctor multispecialty practice in Spokane, Wash. The practice was cited for its successful accounts receivable (A/R) management in the MGMA's Performance and Practice of Successful Medical Groups 2000 report. "We applied continuous quality-improvement efforts to the billing process, looking at it from the point the patient makes an appointment, to checking in, to seeing the doctor, to checking out. We want to make sure the information captured on the charge tickets is accurate," says David Page, MHA, practice administrator. The practice has looked at every step in the process of generating and submitting a claim, and tried to find ways to make the process work better, he says.

Strive To Submit Clean Claims  
The practice's goals are to avoid high A/R and get claims paid the first time they are submitted. To accomplish that, the practice strives to submit only clean claims. "Before we send out a claim, it's reviewed for correct coding, levels of service, documentation and supporting diagnosis codes," says Michelle Davis, business [...]