10 Ways to Increase Receivables in Your Medical Office
March 02, 2009
In these new economic times many of us are tightening our belts and looking for ways to bring up the accounts receivable, especially if we can do it without increasing the number of patients that are seen. Many providers think that if they want to make more money they have to see more patients. In reality what they need to do is to make sure they are getting reimbursed for all the patients they are already seeing and for all the services they are already performing.
Many providers are losing money in their offices and they don't even realize it. There are many things that can be done to prevent that. Some of these may seem obvious to you, but we've seen many an office that could improve in several areas. Here are the top 10:
1. Make sure copays are being collected at the time of the visit. Patients know that they have to pay their copay, but if the office staff isn't asking for it the patient might not offer. The copay should be collected before the patient is seen. We have worked with several offices to get them to make sure the copay is collected at the time of service. They are always amazed in the difference in their bottom line.
2. Get required auths and/or referrals before the patient's visit. If you know the patient is going to require an auth or a referral you should try to make sure you already have it before the patient is seen. The services will be less likely to be denied.
3. Verify patient's insurance info EVERY time they come in. It may seem redundant but the reality is that patients do not always remember to tell you of insurance changes. Your office staff should be asking them every time they come in.
4. Take care of all denials ASAP. I saw a statistic on this that is absolutely staggering. According to a survey by the Medical Association of Billers, only 45% of respondents appeal denied claims. That adds up to a lot of lost money. You have a much better chance of getting a denied claim paid if you handle it quickly. And if the insurance is not going to pay, you will want to notify the patient as soon as possible. Nobody likes to get billed a year after the service date.
5. Do regular patient billing. This may seem like a no brainer, but many offices do not send out regular patient bills. The chance of the patients paying their bill is greater if they know that they are going to receive another bill next month. If your billing is sporadic they may decide to wait to see if you bill them again.
6. Check your electronic reports. If you are submitting claims electronically you should be receiving electronic reports. These reports are very important. If someone is not checking them it could really mess up your cash flow.
If a file was rejected and nobody is reading the reports, you will not know unless you catch it when you are doing your aging reports (we'll talk about these in a minute). There are many things that can cause an entire batch to be kicked out. For example, if you use a # in one patient's address it will cause the entire batch to be rejected. If the reports are being read you would know this happened within 48 hours. If you don't check the reports, these claims are lost.
Then say the patient comes in for another visit and the # is still there, the next batch of claims is rejected too. This can really mess things up. Another thing these reports can alert you to is if a patient's insurance has been terminated. By checking the reports you can find this out within days of the visit so that you can take care of the situation quickly.
7. Make sure coding is being done correctly. Coding can greatly affect your accounts receivable. Whether the doctor is doing the coding himself or you have a certified coder in the office, you need to make sure your coding is accurate. It is a good idea to do an internal audit occasionally to make sure things are being done correctly. You definitely don't want to be under coding, but you don't want to up code either.
8. Run regular aging reports. Many offices consider this a back burner item. They get to it if they have time. That is a big mistake. If regular aging reports are not being run AND worked, money is being lost. There are always claims that were never received, claims that were denied but no eob was received, or claims sent to the patient in error. You also have the electronic claims that may not have made it and even when you are reading the electronic reports there are always a few that seem to slip thru. No matter how tight of a ship you may run, if you don't work your aging reports you are losing money. I always tell doctors they cannot afford not to have someone doing their follow up.
9. Have systems to prevent employee theft. No one likes to think that their employees would steal from them. Unfortunately employee theft seems to be prevalent in this industry. Don't wait until it happens to you. Make sure you have good tracking systems for all money that comes in and goes out. Make it difficult so it's not even tempting. There is no way to completely protect yourself. Some employees can get very creative. Make sure that you are prepared to let an employee go if they are caught stealing or trying to steal.
10. Have someone who understands how to read an eob reading your eobs. It is important that the person entering payments isn't just putting in the amount paid and not checking the eob to make sure the claim was paid correctly.
Were all the services paid for that should have been? Did a code get bundled that should have been allowed separately? Did a test get rejected because the diagnosis wasn't recorded properly on the CMS form? You can't just assume that the payment that the insurance carrier made is correct. The person entering the payments must also be making sure the payment is correct.
One I see often is when I bill 4 units for a physical medicine code and they process it as 1 unit. They are only paying 25% of what they should be. If I didn't notice it the doctor would be out quite a bit of money.
When the eob is read and the payment entered into the system, there may be a patient balance that must be billed. Accuracy of the payment is important in billing the patient the correct balance.
These are just a few ways that an office can increase their accounts receivable. Some of these may not apply to your office, and others may really hit home. You should go over the list and see if there are any areas that your office or any offices you bill for could improve to make sure your providers are getting all that they are entitled to.
Alice Scott, is a cofounder of Solutions Medical Billing. Her background is in business. Over the years she has started several businesses and now she oversees the daily operations and keeps the business running smoothly as well as keeping up the website. www.solutions-medical-billing.com