As a medical billing service, it’s hard to soar with the eagles when your billing software is a turkey.
Turkey software is the kind that gobbles up all your time, keeps you pecking around in data entry, and offers you no way to help your clients stuff the financial holes so common to manual processes.
In other words, you can’t offer Revenue Cycle Management services to your client when all you have is the limited functionality of a desktop medical billing program.
Now, regardless of how long they’ve been practicing, how large their practice is, or what type of medicine they specialize in, all physicians have two things in common; they want to focus their time on treating patients, and they want to keep more of the money they worked hard to earn –it’s about patients, not paperwork.
The MGMA reports that as much as 40 cents of each dollar that a practice brings in is spent on administration, and physicians recognize that coding and financial administration is not their forte, so hiring experts (whether internal or external) to handle the time consuming and problematic task of insurance billing is a no-brain way to spend less time on business, more time practicing medicine, and depending on who they hire, keep more of money they’ve earned.
But if I’m an outsourced medical billing service and all I have is a basic desktop billing software, then I’m on the outside of the practice looking in, with no way to streamline office workflow, eliminate manual processes, or provide valuable Revenue Cycle Management to my client.
In contrast, an end-to-end medical office software with integrated EMR and Practice Management allows a medical billing company to go far beyond data entry and claim management, it enables them to: (1) function as an internal billing department, and (2) act more as a financial advisor, or CFO.
One way medical billers hamstring their efforts is that their current processes keep them on a hamsterwheel of dealing with billing crises while managing kludgy operations that involve manual data entry and stressful calls to practices requesting source material, then re-keying the data over again. Even large medical billing companies with expert billers and strong management spend large chunks of time on tasks that should be automated within software.
For example, a sophisticated integrated system will allow a physician’s staff to quickly and easily check patient eligibility. If eligibility is not checked, the software can instantly alert the front office and notify the billing company, so that what was once a manual process where things fell through the cracks, there are now checks and balances along with new process automation –a vast improvement.
On the back end, claim follow-ups are more thorough. Instead of “Oh, yeah, whatever happened to that claim for Mary Smith?” billing managers can preset alerts. If an insurer does not respond to a claim within 10 days, it is automatically queued for follow-up and pushed to someone’s work dashboard. And there’s no hunting for the information needed for follow up—it’s there at the staffer’s fingertips and can be immediately acted on.
With mundane tasks automated and streamlined, imagine how medical billing companies could evolve into trusted practice consultants. Freed from their bookkeeping tasks—and armed with data—they can work with physicians and practice managers to eliminate much of the $700 billion in administrative waste that US practices see each year.
By moving from a desktop/server medical billing software to a cloud based end-to-end solution, medical billing companies can have their finger on the pulse of a practice’s key revenue drivers and examine and improve every moving part that could compromise practice revenue, including:
- Patient benefit verification
- Co-pay collection
- Timely filing
- Superbill tracking
- Contract management
- Denial management
- Underpayments (all payments compared to RVUs and contracted rates)
- Collection and recovery management
- Employee theft
Last but definitely not least, an end-to-end practice system gives billers instant access to clinical notes, so they can use their expertise to ensure that every patient’s claim is coded to the highest level of specificity with no fear of upcoding, which is cited to be a fear of 70% of physicians and a significant loss of practice revenue.
Now ask yourself: What physician would not want to work with a billing company that can increase revenue through proper coding while automating processes, fixing inefficiencies and reducing waste?
So, it’s time to step back and see the forest from the trees. Get rid of your turkey software that keeps your wings clipped in manual processing, and start soaring with the eagles with a unified practice management system that offers true revenue cycle management intelligence and advanced practice automation that not only gives your client increased transparency, but a better bottom line to boot.
Last Updated on December 12, 2013