Evaluation

Crucial to billing success is evaluating the process on a routine basis. For effective assessment, your practice should institute goals and written standards. Important to remember: this will be helpful for testing the success of the individual practice, and not for comparing between practices. True competitive comparisons would only work if the practices were identical with patient mix, revenue streams, and more.

  • One important benchmark is the days outstanding for accounts receivable. For example, outstanding payments that are 45-60 days old should represent the largest percentage, while older than 90 days should not exceed 15 percent. This is a good starting point for many practices.
  • Assessment through simple or complicated figures is helpful, but evaluation must also be done in other ways. There must be a tracking system for errors. Determining the type of errors and the amount of occurrence can give you important insight into how billings are implemented. In addition, track payment denials. Seeing a compiled list of why denials occur can pinpoint errors that might be at cause.

With this assessment data in hand, look at the broader picture.:

  • Do the same errors keep happening?
  • Do certain patients continue to crop up as problems?
  • Do you continue to have denials for certain reasons?

For effective billing, consider the staff perspective, the well-communicated process, and the evaluation procedures. Only when all the components combine will billing errors be reduced and revenue increased.

Sources for this article:

Brown, T., Bryant, R., and Menier, S. Managing Accounts Receivable. Hematology/Oncology News and Issues.

Sacher, J. and Martin, M.L. Are you in Compliance? Keeping up with Billing and Coding Regulations. Physician's Practice.

Woodcock, E. Billing Blunders: Is your Practice Making Costly Mistakes? Physician's Practice.

Medical Billing Clearinghouses – benefits and risks of outsourcing your practice's billing. 

About the Author

Amy Lillard was a regulatory and marketing professional at the Feinberg School of Medicine at Northwestern University for 4 years prior to writing on healthcare topics.

The author discloses no financial conflicts of interest with the content of this article.

Topics #billing benchmark #medical billing