The Executive Suite: 6 back office billing strategies

The front desk staff is essential for checking in patients, collecting copays, and verifying insurance. But there’s more to the story, and out of sight doesn’t mean out of mind. Much of the heavy lifting for billing and collections is done in the back office, so it’s even more important to have a deep bench of talent, says Tammie Olson, manager and coding and compliance strategist at Management Resource Group.

In this two-part series, Olson, who works at the Ocean Springs, Miss., firm, offers financial management and support services for the healthcare community. She shares six ways to get your back office team to bring their best game to your billing and collections efforts. Click here to see her suggestions for the front office.

Train select employees to set up payment plans. Often, the front desk will discover the need to set up a payment plan with self-pay patients or patients with an outstanding balance. But the actual arrangement is made by the back office staff. It’s crucial these plans be consistent and fair for all patients. You need to have one or two people in your back office who know how to correctly set up plans. Training back office staff will also alleviate the pressure on the front desk to make decisions about waiving payments—or let their emotions clout their decision-making.

Reconcile encounter forms and bill claims daily. If there are any questions about the services rendered, seek clarification from the provider. Your billers should be knowledgeable about appropriate modifiers and when to use them. Make sure your billers are submitting clean claims.

Clean claims get paid the first time around and stand up to a potential audit.

Analyze insurance denials and develop processes to reduce them. Is there misuse of modifiers? Are denials related to medical necessity? Outdated codes? If you make the effort to track the denials and see where you’re making mistakes, the time spent will be rewarded with higher and prompter payments. Similarly, have processes in place for correcting and refiling denied claims in a timely manner.

Follow up on accounts receivable daily. Run insurance aging reports and review anything more than 60 days old. You may have to call the payer in some cases, but most claims pay within 21 to 30 days of submission. If this is not the case, you need to investigate what’s going on.

Conduct patient flow analyses regularly. Time is money, and anytime there is a patient flow problem, it costs the practice. The office manager or practice manager should analyze patient flow for all services provided, find problems, and identify ways to streamline the processes. For example, you might perform a patient flow study. This will tell you how long it takes patients to complete the check-in process and be placed in the exam room. This will help you track and streamline processes at the front desk. A shorter check-in process can improve patient satisfaction and help keep providers from falling behind schedule.

Designate one person to follow-up on patient balances. Your front office is making sure patients are aware of their balances. Someone in the back needs to be tasked with calling the patients and asking for payments. Many practices outsource this responsibility. It’s less important who makes the calls so long as follow-ups are conducted on an ongoing and regular basis.

When the back office takes these tasks seriously, processes proceed more smoothly throughout the practice. When that happens, your bottom-line will see a bump in revenue. That’s a bonus for everyone in the practice.