Workflow and Productivity Assessment
Workflow and productivity is essential to the success of the medical office. A streamlined workflow will naturally improve employee poductivity. A medical office without efficient ways to perform necessary job duties cannot perform them effectively.
Be sure your policy includes a continuing education program to make sure all employees are kept up-to-date on office policies, compliance and job specific requirements.
The success of the Medical Office largely depends on how well the front end staff performs.
- Registration Accuracy: The cycle of a patient account originates with the initial entry of patient demographic information which includes patient demographics and insurance information. Invalid information can delay payment.
- Scheduling Efficiency: Does your medical office have a high "no show" rate? One way to reduce no shows is by the use of online patient scheduling. Patients can manage, schedule or reschedule their own appointments which makes "no shows" less likely.
- Patient Satisfaction: Providing high quality care and excellent customer service will prevent loss of revenue for the medical office due to a high level of patient satisfaction.
Documentation and Coding
A documentation and coding assessment ensures that every patient chart is accurate, complete, and meets coding standards compliance. Proper documentation and coding is essential to accurate charge capture, effective billing and collections, and denials management.
- Are you still using the old paper-based charting system? Switching to an electronic health record (EHR) can improve accuracy and reduce costs.
- Proper assignment of emergency & management (E/M) level of service to the correlating diagnosis or ICD-9 codes are important for reimbursement and coding compliance.
- Don't allow transcription and medical records coding delays affect the billing cycle. Set the timeframe for completion at a minimum of 3 - 5 days.
Billing and Collections
Billing and collections best practices show four ways to manage the work flow for maximum reimbursement.
- Work all accounts receivable accounts from high dollar to low dollar. This results in lower AR days meaning your medical office is collecting more money in a shorter period of time.
- At least 90% of medical office claims should be billed electronically. Electronic claims usually process within 7 to 10 days. Paper claims can take 30 days or longer.
- Use web-based tools to check claim status. This can take 2-3 minutes versus the 20-30 minutes on hold with an insurance company.
- Identify causes of denials and underpayments in order to avoid future revenue loss or delay. This also means making sure denials are resolved in a timely manner.
Miscellaneous Workflow Questions
- Have tasks been clearly defined by job responsibility?
- How will you make the transition form paper records to EMR (electronic medical record)?
- Do you have an ongoing training and development plan for all employees?
- Have all job areas been identified to improving workflow success?
- Have you evaluated the layout of the office and patient areas?
- Do you have the most current and up-to-date HIT (health information technology)?
An important part of the revenue cycle is upfront collections. Upfront collections reduce the number of patient accounts that end up in bad debt or collections status. It is easier to collect from patients prior to services being rendered than 60 days later after insurance has finally paid... Read more
Medical coding is a major factor in obtaining insurance reimbursement as well as maintaining patient records. Coding claims accurately lets the insurance payer know the illness or injury of the patient and the method of treatment... Read more
The fast pace of the medical office is the ideal environment for billing errors. Patients are showing up in 15 minute intervals, the phones are constantly ringing and not to mention several walk-ins have shown up and your office staff is doing the best they can to still offer excellent customer service... Read more