Wiki Number of Billers Needed?

Lynne77

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Hello,

I am a billing manager for a mid size dermatology practice. We have 23 providers and are about to add another. The majority of our providers are full time and to give you an idea on volume, we see close to 7,000 patients per month. I'm trying to get an idea of how many billers we should have in our depatment. Currently, I have 1 patient collections rep, 5 insurance billers (who post payments, work denials, and work AR), and 1 credentialing specialist who also helps out in billing when she has spare time) and I don't think this is enough.

I'd like to get an idea of how many people other practices have in their billing departmennts. If you can please provide the size of your practice (# of doctors and visits per month) and the number of billers in your department, it may give me at least a rough idea of where we need to be and will be greatly appreciated!

Thanks!
 
I'm of the opinion that there is no "formula" you can apply to determine how many employees a practice should have in any specific department or even overall. One of the biggest factors is exactly what responsibilities those with "billing" titles do. Another big factor can be your software. Also your payor mix.
Do your billers ever also code? How automated is your insurance payment posting? In some practices, the biller may cover front desk for lunches, or vacations. Other practices the front desk is doing all eligibility and referral work.
I would think for 23 providers, 6 1/2 billers is in the ballpark. Before expanding the department, I would evaluate some things.
1) Would adding another biller bring additional revenue? For example, are you now writing off claims simply because no one could follow up in a timely manner?
2) Is there a specific obstacle (software, hardware, difficult or very chatty employee) that impacts productivity now? Sometimes it's a rather minor thing that no one thinks of and everyone has gotten used to a workaround, even though it takes much longer. Simple example: billers work in a separate office across the hall, but the only fax machine is by the reception desk 4 rooms away. Each biller send 5 faxes a day, and every time they do, they chat for 10 minutes with the front desk or MA desk. Having paperless faxing right from their computers makes them more productive.
3) If the billers are behind, and it seems your front desk, or MAs or some one else in the office is not as busy, re-evaluate where the responsibility lines are.
4) Really look at your billing software. Contact your vendor for a refresher or reach out to other offices using the same software. Sometimes there's a feature you don't know about, or an easier way for some tasks to be done.
5) Payor mix. Do you have a specific payor that denies 20% of your initial claim submissions? Are they also a low payor? You might drop a problem insurance carrier, and not impact your bottom line.

As a reference, my practice is currently 3 MD, 4 PA. 2 billers, but a separate corporate office does 98% of claim follow up and all payment posting. One of my billers is a coder, and 95% of her time is spent coding and entering office charges which allows the clinicians to be more productive. The other biller basically spends the bulk of her day in the multiple clunky computer systems doing eligibility, checking referrals, and corresponding with the corporate billing office. I am a practice manager, but I also do some coding and reviewing billing reports. When we were a private practice with similar volume, but a much more robust and responsive billing system, we had the same number of billers and did all billing aspects (eligibility, coding, follow up, posting) in house.
 
We are a privately owned, primary care, Internal Medicine/Pediatric practice. We currently have 5 physicians and 5 mid-levels. We are open 6 days a week and currently see between 2700 - 3200 patients per month that result in an E/M visit. That number doesn't include patients that come in for lab or injections only. Our physicians also round on their own hospital patients that we bill for as well. My billing team is currently at 6 which includes myself. Everyone has specific tasks and areas of billing they are responsible for. In my opinion its all about having the right people on your team and in the right positions, processes and protocols.
 
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