the division of labor will be. some providers may be well-versed in how outsourcing works and may know what they hope to achieve. Others may have never worked with a billing company and don’t know what to expect. By finding out if a provider is solely focused on improving financial metrics, like average days in accounts receivable (a/r), or if other factors, such as patient collections, are top of mind, billing companies can ensure they start every relationship on the right foot. With a better understanding of what the client expects, billing companies also have a framework to use to discuss and educate providers about the ins and outs of their operation so there won’t be any surprises a few weeks or months into the relationship. 3. ESTABLISH KEY METRICS AND BENCHMARKS UPFRONT. The best way to deliver a client’s desired results is to establish benchmarks at the beginning of the relationship and consistently measure against them to ensure collection efforts are on track. In most cases, days in a/r is the key metric that all clients will want to track. aside from providing the overall a/r number, it is also a good idea to segment days in a/r by payor or financial class so that you can easily drill down and identify any potential issues that need to be addressed. Other key metrics to monitor include a/r over 120, adjusted (or net) collections rate, denial rates, and rejection rates. 4. DESIGNATE AN ACCOUNT REPRESENTATIVE FOR EACH CLIENT. Having one person who is personally responsible for overseeing a client’s account not only makes it easier to address any concerns that may arise, but it also gives providers the confidence that their billing company is on their side and understands their unique requirements. This approach can be especially helpful during the implementation period, which often feels lengthy and protracted to providers anxious to see billing data and quantifiable results. 5. INTEGRATE SOLUTIONS WHERE POSSIBLE. aside from ensuring your billing company’s revenue cycle management solution is robust enough to effectively manage provider claims, it’s also critical to find one that can easily integrate or interface with the technologies most providers have in place, including electronic health records (eHrs) and practice management systems. as paper-based superbills quickly give way to automated tools that streamline clinical documentation and billing workflow, integration with existing technologies – as well as those from clearinghouses – allows for fast and easy solution upgrades that help providers improve productivity and simplify workflow. 6. STAY ON THE CUTTING EDGE. Without the features and functionality that today’s clients desire, billing companies could miss out on opportunities to secure new client relationships or expand existing ones. Continuously review and update your company’s capabilities 24 HBma BIllINg • NOVemBer.DeCemBer.2014 to ensure they reflect the current needs of the market. For example, as patient financial responsibility continues to climb, more practices want convenient payment and billing options they can offer to their patients, such as portals and online bill pay. 7. BE TRANSPARENT. For many providers, one of the most difficult aspects of outsourcing their billing is the loss of control they feel. By finding ways to be as transparent as possible, billing companies can alleviate this concern and make providers more comfortable with the idea of having a third party manage their finances. For example, allowing some level of access to your company’s software and clearinghouse may help put providers at ease. Carefully consider ways you can allow clients to see what is happening at every step of the revenue cycle, from big picture strategies down to the details related to individual claims. In addition, be sure to provide a clear reconciliation of exactly what payments are received and posted so clients can easily view a detailed record of how their funds are handled throughout the collections process. 8. PROVIDE FREQUENT, DETAILED REPORTS. While it’s up to each billing company to determine how often they want to provide reports and the format they want to use, a good rule of thumb is to deliver reports detailing established key metrics, such as average days in a/r and denial rates, on a monthly basis, at a minimum. Whether reports are delivered in person, on paper, or electronically, they should clearly outline how a provider organization is performing on key revenue cycle fronts, if claims are being paid promptly, and if payors are abiding by contract terms. It is also helpful if the designated account representative takes time to speak with the provider organization about each report, to make sure they understand where they are performing well and how they can improve. A Personalized Approach Taking steps to build deeper, more meaningful connections with providers allows billing companies to set themselves apart from the competition, both during the sales process and beyond. By encouraging open communication and establishing common goals, billing companies can cultivate stronger relationships, improve retention rates, and bolster the bottom line in an era of healthcare reform. Karin Anzalone is director of training at Healthpac, a provider of medical billing and practice management solutions. Laura Bridge is vice president of client services at Navicure, a healthcare billing and payments provider.
Billing_NovDec14
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