Published - September 2019

It's About Profits Too
By Dave Jakielo

I know there are various reasons why you may like the Medical Billing Industry. Some are on a mission to ensure providers can remain economically viable, others find swimming through the oceans of rules and regulations challenging and rewarding, and I'm sure many like providing a living for your employees.

Whatever your motivation to remain in this business, you need to keep in mind that you must remain profitable, unless medical billing is your hobby. And remaining profitable is getting a bit more challenging these days due to rising operating expenses, the games insurers play, and an increase in employee turnover in many parts of the country.

However, as I visit various medical billing companies, I have seen some of the latest endeavors people are deploying to remain ahead of the cost versus profit curve and I'd like to share them with you in case you are not currently aware of some of the latest tools.

Many third-party insurers are doing a better job of making patients' eligibility information available via the web, which allows eligibility verification to occur before you submit a claim. If your clearinghouse offers this service, take advantage of it. I've seen some companies say, "Verifying the patient's insurance costs money and I don't want that added expense." That is being penny wise and pound foolish, because it's much more expensive to work a claim that has been rejected due to incorrect coverage information.

Another important feature is that you should have a patient portal where the patient can pay their bill online, eliminating the need to call your office and provide credit card information. Some patients are paranoid about giving out credit card information over the phone, thinking their information may end up in the wrong hands, so they will never call. Additionally, some portal vendors offer the ability to utilize "credit card on file" where you can automatically charge a patient's card for their deductible and copay after the claim has been adjudicated or the patient can set up an automatic monthly payment plan to satisfy their debt.

We know this is a complex and ever-changing industry. It seems that once we understand the rules, the payers change them, and it is not unusual to find out about the changes by accident. So it is imperative that we communicate these changes to everyone in our company on a timely basis. Some companies put all the rules on a share drive, so everyone has access, but the best companies not only share the information, they also hold Lunch and Learns on a regular basis. This is an effective way to ensure everyone hears the same message and allows for a group discussion relating to any questions someone may have. I recommend at least a monthly Lunch and Learn session on relevant topics or reviewing skillsólike effectively delegating.

It's not just your responsibility to figure out how to maintain a healthy bottom line; you need to engage others. Why not empower all of your employees to come up with ideas to save money, improve client service, or recommend operational process improvements? And if their ideas do save money, why not share the savings with the employee? You could agree to split the monetary savings or allow them to choose time off or another benefit. If you don't ask for suggestions, don't assume people will voluntarily come up with ideas and share them with you. It seems like that would be common sense, but improving operations or reducing costs is not as important to them as it is to you.

Lastly, a way to improve your overall company is to set and share goals. Many companies I visit don't even have the basic Key Performance Indicators (KPIs) goals established or if they do, for some unknown reason, they don't share them with their staff nor hold them accountable for achieving the targets. Your KPIs should at least be set for Days in Accounts Receivable, 30 or less based on specialty, and for percent of accounts over 60 days old, 20 percent or less.

Above are only a few suggestions I wanted to share to help ensure you can remain a viable company, but don't forget you need to be a student of our industry and study each and every new technology and process that comes along. While not every new thing will be appropriate for your operation, continuing to do things the way you always have is a sure recipe for disaster.

Dave Jakielo, CHBME, is an international speaker, consultant, executive coach, and author, and is president of Seminars & Consulting. Dave is past president of Healthcare Billing and Management Association and the National Speakers Association Pittsburgh Chapter. Sign up for his FREE weekly Success Tips at Dave can be reached via email; phone 412-921-0976.

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