Medical Billing

A weak medical billing staff can undermine the best technology and billing processes. Medical Billing success requires great medical billing employees. Developing a strong medical billing team is a difficult, but worthwhile effort. Here is how to make it happen:

1) Installing a well-defined and predictable method for recruiting, identifying, hiring and keeping great medical billers:

Medical billing is a critical function and the process for finding and selecting medical billing employees must reflect the criticality of the job. You would not hire an accountant or an attorney based upon a few questions about what they liked or did not like about previous jobs, you should not hire medical billers with any less rigorous a process. Install multiple interviews and multiple testing levels. Test for billing knowledge, work style and work effort. Check references and check criminal history.

The leading billing organizations train to develop desired quality. Junior staff members must pass demanding training programs-junior team members are developed into billers, capable of following the measured and monitored billing process. In addition, staff is trained throughout the year in latest payer rules, follow-up techniques and compliance guidelines. A dedicated Compliance Officer is responsible for all additional HIPAA and OIG training.

The best staff is retained; weak staff released. The billing organization's staff is evaluated every year to assure proper development and progress. Evaluations are based on tangible, measurable targets and quality indicators. Best performers are properly rewarded and the lowest 10% of performers are asked to leave. This should be done methodically in an effort to continuously improve the quality of billing staff.

2) Focus your team members: The best medical billing processes are designed to allow individuals to specialize in specific areas such as charge posting, insurance follow-up or payment posting. Such specialization allows the individuals to become true experts capable of spotting issues quickly that billers spending their time performing multiple tasks might miss.

3) Invest heavily in analytical efforts: Continuous improvement of the billing process and the billing team requires significant and on-going analytical efforts. By measuring key factors about both payers and the billing process, a billing group can speed up collections, lower denials and lower the cost of the billing process.

4) Compensate your medical billing specialists based upon performance, not effort: Your billing department should succeed when the practice succeeds. Many good billing systems have been undermined by a compensation approach that does not give the medical billing team the proper motivation to doggedly and efficiently pursue the practice's claims. Remember to insure the compensation system falls with the OIG's guidelines.

These steps provide a foundation for growing a medical billing team that will be second to none.

Copyright 2008 by Carl Mays II