Product-line billing can mean more profits
Product-line billing can mean more profits
Change may make sense for your practice
Consumer goods companies such as Coca-Cola and Nike found out long ago that grouping employees in teams by product line, rather than by function, goes a long way toward increased efficiency and job satisfaction. Your practice’s billing system has the same potential for reorganization and enhancement, according to one Pennsylvania consultant.
Consider appointing a product-line manager for each specialty, making that person responsible for seeing that various steps in the billing process are completed for their related claims, suggests Heather Auld, director of training and consulting services for Physician Billing Solutions of Wayne, PA.
Under the product-line approach, one person essentially assumes responsibility for the major components of the billing and accounts receivable process by practice specialty, or product line, depending on the nature of the practice. (See story on p. 21 for an explanation of how to implement this concept in a multispecialty practice.) The product-line manager, for instance, completes the processing of charge entry claims, rejection posting, and resolution, along with any needed follow-up, notes Auld.
One practice’s experience
Auld personally supervised the reorganization of a 200-physician multispecialty group into a product-line billing process. The driving force behind this group’s conversion to product-line billing: problems collecting and correctly recording accounts receivable, poor morale, and lack of job ownership among employees, says Auld.
Employees were not accepting accountability for mistakes in the billing area when they occurred. Meanwhile, the physicians in the practice were becoming increasingly irritated that there was no single contact they could go to for answers about claims or billing problems.
The transition of the billing staff, which includes 35 off-site employees and 15 to 20 on-site employees, took four to six weeks. During this time, the practice redesigned the billing staff’s organizational chart, trained employees on their new job duties and physically retooled the billing office.
After job duties and functions were redesigned, openings for new positions created by the reorganization were posted so that current employees could apply. This is very important element of the transformation as it creates a career path for otherwise dead-end jobs which, in turn, improves morale, Auld says.
"Plus to get staff to buy into the concept it is important that you offer them an opportunity to advance, rather than automatically bringing in people from the outside," she adds.
Although new jobs were created by the reorganization, there was no net increase in the number of billing staff positions. About 60% of the billing department employees were given more senior level jobs, while salaries rose an average 10%.
The product-line managers report to a division supervisor or coordinator who oversees several different product lines. This supervisor reports to the manager of billing operations.
The reorganized billing staff lost some functions but gained others. For example, outpatient charge entry was moved to the front desk billing personnel, and all other date entry work was turned over to a separate data entry department. However, product-line billers took over responsibility for inpatient charge entries because billing department managers this duty needed to be performed by someone with a higher level of knowledge about coding and billing.
The practice decided to keep the payment posting function in a separate department because the volume of work required was too great for product-line managers in a large practice to absorb, Auld says. However, the function probably could be absorbed by a product-line manager in a smaller practice.
Increased accountability a major benefit
Benefits of adapting the same approach that this 200-physician multispecialty practice did are numerous. The biggest benefit of giving a single person responsibility for the complete billing process: increased accountability and sense of ownership in the job. "When numerous individuals are responsible for completing the billing process, it can sometimes be difficult to pinpoint where your real problem areas are, as individuals can try to shift responsibility or blame around," notes Auld. "But when one person is responsible for the specialty, however, they have to take ownership and final responsibility."
Practice administrators benefit for this reason: "By empowering your product-line managers with information and data to analyze the entire process, they’re better able to assess billing reports and productivity indicators to determine how to improve their own work," says Auld.
A practice manager no longer has to investigate the entire process to determine where problems lie. Now there is a product-line manager to whom they can turn for answers about that particular situation in order to pinpoint problem areas in that specialty, says Auld.
Another advantage of the product-line approach: It allows people to develop a wider perspective, which can help them see and anticipate potential billing and claims processing problems unique to the specialty.
"Ideally, they learn something new each time they get a claim rejected in their area, which will help eliminate the problem and reduce the payment turnaround the next time that kind of claim is submitted," says Auld.
Plus, with increased auditing and emphasis on properly documenting and following regulatory guidelines, product-line managers are positioned to keep better track of how the changing regulatory environment affects their specialties, which can prevent problems from occurring in the first place. "Together, practice administrators and billing specialists can set individualized goals for each specialty, taking into account factors that specifically influence each product line," says Auld.
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