Use training to expand your in-house expertise

The basics of a billing training program

Most studies show it’s newer billers and coders who make most claim-related mistakes. Even so, many practices fail to give their new billing staff adequate training in the fundamentals of their job, which includes an understanding of how their work contributes to the entire billing process, says Donna Sherwin, president of PBSI, a Wayne, PA, firm that provides staffing and training services to physician billing offices.

A lack of basic training and cross-training between billers, coders, posters, and schedulers makes it easier to overlook mistakes or inconsistencies, because each function only knows its piece of the total reimbursement pie. The first step to ensuring every biller and coder in the practice has a basic level of competency is to "start with a uniform and basic level of testing and training, then selectively add more training, as needed," says Sherman. "The idea is that the practice benefits when everyone is working towards the same common goal: Maximization of reimbursement through timely and accurate billing while maintaining an optimal level of patient treatment and satisfaction," she notes.

"This not only ensures that all personnel are reading from the same page, but it will give your current employees knowledge that may help them move between jobs in the organization more easily," she says. "As a result, you will have created a much happier and more productive employee, from the front desk person to the accounts receivable management supervisor."

Before implementing any biller training program, Sherwin recommends practices determine exactly what it is they want each staff member to know. This could include such things as:

— patient flow from the initial call to the resolution of an account receivable, including a review of the basic functions and/or positions needed throughout the process;

— a minimum level of medical terminology;

— the importance of CPT 4 and ICD 9 codes;

— basic self-pay and third-party billing rules and procedures.

Once you’ve decided what you want your training program to concentrate on, Sherwin says you should test each staffer to establish knowledge level in each area. That information will then be used to refine and focus the particulars of the training. Based on her experience, this basic training should take between 15 and 20 hours. Depending on the size of the organization, it could take several core sessions before all staff have completed the introductory training activity.

To help facilitate the training process, Sherwin suggests dividing the program into several self-contained modules. For example, one module might be an introduction to medical terminology with a concentration on the terms most often used in your practice. Another might be on the importance of CPT codes, including a brief introduction to the CPT book and the most often used CPT codes in your practice. A similar module might be presented for ICD 9 codes.

Sherwin also says flowcharts are an excellent learning tool, particularly for visualizing how a patient moves through the system. The same applies for following a charge from initial data entry to resolution of the account. "All trainees should be tested again to ensure that the training was effective and that your objectives have been met. I would suggest that you establish a minimum acceptable grade, and that anyone who does not meet the minimum be required to retake the basic training," says Sherwin.

Once the core conceptual training has taken place, you’re then able to begin cross-training workers. Sherwin says each person should immediately begin cross-training in functions other than the ones in which they normally work after completing their core conceptual training. Plus, "if you are organized along product lines in which one person is responsible for multiple functions within one product line, you will have to provide them with multiple function training," she says.

If done correctly, this training regimen will teach any entry-level employee to perform effectively as an appointment scheduler, a registrar, or a charge entry person, while also "providing an excellent base from which to build payment posters and junior-level collectors," says Sherwin.