Wiki Ratio of billing Staff to Claims Filed?

[acbarnes]

I am trying to determine how many billing staff I should employ based on claims filed. I do not want to base it on providers since providers produce at different rates. Any suggestions or research will be helpful.

Thanks,
Anna Barnes, CPC, CGSCS

 

[ARCPC9491]

You have to take an average of claims for each physician, add it up, and figure out your productivity standards for your billers. If you have on average 320 claims to file per day, and you feel like your billers should put in 100 per day, you would need roughly 3 full time employees... just an example

I don't know if these billers have other responsibilities or duties. If they are answer phones, putting in charges, posting payments, etc.... you need to take all that into account as well.

 

[acbarnes]

Yes, thank you. It is very difficult. I have 9 full time surgeons and 1 part-time PT that produce at very levels. I have...

1 full-time billing administartor who oversees billing workload as well as enters and performs random pre-audits on all surgical charge slips.

1 full-time posting associate-posts all EOBs for the practice as well as credentialing and OSHA

1 part-time appeal associate- writes all appeals for denials

1 full-time claim/EOB reviewer who works all rejected denied claims as well as aged receivable lists

1 full-time patient associate- verifies ins eligibility on office patients as well as takes all patient billing calls

I am always under pressure to watch HR dollars and wanted to see if there were any numbers to use for comparison. Every practice is different.