We follow the same principles that corporations follow in managing their receivables and cash flows. Cash is king. We believe that the key to a well run medical billing process is constant flow of communications between the front and back ends of a patient encounter through billing and collections. MCMS has developed methods and systems to assist your practice realize optimum returns on outsourcing medical billing. Outsourcing many services, such as medical billing, is a cost effective way for providers to gain the highest reimbursement while remaining competitive in a demanding profession. Allowing an outside company to “bear the burden” placed upon medical practices by insurance companies frees up the healthcare provider to provide the highest level of quality care without these distractions. MCMS will also handle all patient inquiries, thus reducing the patient call volume to your office. Many providers have found that simply reducing the volume of calls to their office as allows staff to more effectively attend to office patients’ needs. Less interruptions leads to higher productivity.
Is my practice staffed correctly?
If you have a low collection ratio or your collection rate is trending downwards, your staff probably needs to be restructured. By taking a snapshot of your registration-billing-collecting process, we can determine where the system bottlenecks / problems exist and suggest restructuring of billing functions leading to increased cash flow. Another practice staffing consideration is the practice’s accepted insurance carriers. Does your practice handle many Medicare patients or is patient volume more concentrated on Managed Care HMOs, Medicaid and union patients?
We find that, in many instances, practices chose to outsource certain parts of the billing process to MCMS based upon recognizing that their staff is proficient at executing certain tasks but not others. If you are having trouble finding competent billing people, or you don’t want to incur significant practice management system expense – or both – outsourcing the entire process is the way to proceed. If you are pleased with your staff’s performance in certain areas but your collections ratio is low, outsourcing your follow-up and over 90 days claims is advisable.
My percent of collections keeps trending downwards. My Accounts Receivable is out of control.
The first step to moving collections in the right direction is to examine your practice’s claims follow-up process and find ways to expedite and streamline it. First, find out what your practice management system can do for your practice and maximize its functionality. We find that many practice’s staff are able to handle the systems but don’t have time or knowledge on how to maximize its functionality to increase profits. At a minimum, your practice management system should be able to automatically track follow-up reasons. This information allows a competent biller to provide feedback to the coders, the physicians and front-desk clerks on and correct the reason for the follow-up – at the source. If your system does not have this ability or you find billing staff unable to track these reasons, you should consider outsourcing this part of your practice’s billing process.
My patient balances are out of control.
First step is to take a hard look at your statements. Is your system able to provide information on the type of charges, reimbursement received and reason for the balance? If a patient is unsure of what they owe and the reason, they will not pay the balance. Do you have a patient collection policy? Are you or your staff enforcing it? Have you set patient payment plan parameters for your staff? Many times, billing staff focuses their efforts on collecting from insurance carriers but not the patient. Patient collection is time consuming and requires very good understanding of insurance reimbursement policies. In many instances, a knowledgeable biller can settle a patient balance during the first call by providing an informed explanation of services provided to the patient.
I have invested in “state-of-the-art” practice management software and I don’t seem to be getting a return on my investment.
You invested $5,000 to $10,000 on a practice management system and this system is not giving you expected returns. The first question to ask is – is my staff taking advantage of the system I have provided them with? Is there a person in the practice designated to address system issues as they come up and obtain quick resolutions? Do you conduct weekly staff meetings to discuss issues and educate staff on common errors and new insurance edits affecting your claims? Is spending time fixing software issues is why I got into the field of medicine?
Production Without the Waste
To maintain many services in-house requires additional staff to perform these activities. You have to train staff, which takes at least three to six months before an adequate productivity level is realized. In today’s job market, finding quality staff can be challenging and expensive. Not only must you offer competitive salaries , but you may also have to offer benefits including vacation time, overtime, sick pay, medical benefits and even profit-sharing to attract the additional quality personnel. The more personnel you have on staff, the higher the unemployment insurance rates, and so on…with MCMS you have none of these costs.