Archive for April, 2011


April 28, 2011

“Integrity has no need for rules.”   – Albert Camus


10 Ways to Improve Your Accounts Receivable

April 25, 2011

Streamline information flow and accelerate turnaround with these tips on managing patient encounters.

Receiving maximum reimbursement with quick A/R turnaround in any healthcare practice requires careful attention to obtaining, documenting and communicating information. From the time a patient schedules a visit until the charge is closed out, proper management of information to and from your billing representative means the difference between fast reimbursement cycles and slow, drawn out A/R. Information about insurance coverage, demographics, diagnosis and status of claims should flow clearly and efficiently to support a clean claim submission the first time around.

Here are 10 opportunities in the lifecycle of a patient encounter where efficient management of information will improve your Accounts Receivable (A/R).

  1. Initial Patient Contact – Front office staff or the patient scheduler should capture ALL pertinent information when a patient calls to schedule an appointment. Capturing general information like name, phone number and reason for appointment is a good start, but make sure you’re catching payor information as well. Does the patient have insurance? If so, who is the carrier, what’s their plan number? If not insured, are they prepared to pay up front and have they been briefed on your payment terms? Either way, answers to these questions will help in the insurance verification step and/or set proper expectations for payment at the time of service.
  2. Insurance Verification – Either the scheduler or billing representative should use the information from initial patient contact to confirm with carriers BEFORE the office visit. This opportunity offers the chance to confirm enrollment, coverage levels, co-pays/deductibles, etc. Traditional verification of benefits over the phone is effective but time consuming; remember that you can usually save a lot of time using on-line interfaces offered by many carriers today. If the result is “no coverage” for this visit, or the carrier is unable to verify coverage, a follow up call to the patient should yield updated coverage information or at least guarantee everyone is aware of payment responsibilities.
  3. Patient Registration – When the patient arrives at the office, the receptionist or a member of the front desk staff should verify ALL registration forms are accurate and complete. If it’s an existing patient, the receptionist should re-confirm that records are up to date. This step is the key to obtaining/confirming the detailed demographic data required for insurance claim submission – if anything is incorrect or missing, reimbursements can be delayed as much as a month or more. It’s also helpful for front desk staff to reiterate any out of pocket expense (such a deductible, co-pay, co-insurance) or self pay obligations at this time to confirm the patient is prepared to remit payment once the visit is complete if not before services are rendered.
  4. Provide Care & Document Services – While the patient is in the exam room, or immediately following the visit, all diagnosis and care should be clearly documented on encounter forms. Patient forms are then forwarded to the front to cross reference with information gathered during insurance verification in Step 2, and the bill for co-pays and self-pay patients is generated, if this was not done before the services were rendered.
  5. Collect Co-payment – All patients should be required to stop by the cashier or reception desk to remit payment for co-pays, self-pay, etc. BEFORE they leave. If preceding steps are completed properly patients will already be aware of obligations, so there shouldn’t be any surprises. A receipt can also be generated now for the billing representative to document exactly how much was remitted by the patient, should any later balance billing be necessary.
  6. Claim Generation, Submission, and Carrier Review – Clean claim submission is not just dependent on the information gained in steps 1 through 5, but also on processes that manage data efficiently. A good practice management or medical billing software will address this need, but as with other areas in life remember that you usually get what you pay for – it’s usually best to not cut corners. The alternative to spending thousands on software is teaming with a professional medical billing company for, usually, a nominal percentage of receivables. Either way, if information is missing at initial claim submission, denial can add several weeks to the reimbursement process. If all moves smoothly, reimbursements can be forthcoming in as little as 1-2 weeks!
  7. Insurance Reimbursement Received/Documented – Hopefully, all of the preceding steps have progressed smoothly and a clean claim was submitted. Our next step in managing claim information is proper documentation of reimbursements in the medical billing record. This step can often be simplified through electronic remittance and EOB notifications. If you’re not able to use electronic EOBs, then it becomes critical the billing representative is thorough in manual entry of all EOBs received. Keeping close eye on your EOBs – timing as well as reimbursement rates – can also identify which carriers are paying quicker and which might require a follow up call.
  8. Patient Invoicing – This step is about communication with patients. Just like carriers, providing patients with thorough information will further help to reduce turnaround time and minimize questions. Be clear and note dates of service, insurance payments, fees collected at time of service, and total amount due. These statements should be sent out as soon as an insurance determination is confirmed. Many statistics have shown the sooner an invoice is sent, the more likely, and faster, it will be paid.
  9. Enter Patient Payment – Upon receipt of the patient payment, the billing representative should enter payment information into the billing system and prepare to close out the charge. If payment is not received within a reasonable amount of time (i.e. 30 days), the practice should have clear policies in place for next steps. Small balances of say, under $5, might be taken as a write off; for larger balances a second invoice might be sent or the patient may be sent to a Collection Agency for further action. Regardless of your policies, don’t delay in taking action. A/R suffers most when these balances go unaddressed, carrying forward month after month.
  10. Close Out Charge – Once final payment has been received, or a determination has been made to write off or send to collections, the billing representative should waste no time in closing out the charge.

These steps can generally be applied similarly with any patient visit in almost any specialty or medical office. Whether you have a staff of 20 or just one person, one loop hole creates a chain reaction and it affects the entire process.  Keep these opportunities in mind as you consider ways to improve the flow of information and reduce your practice’s A/R turnaround.


April 21, 2011

“The road to happiness lies in two simple principles: find what it is that interests you and that you can do well, and when you find it put your whole soul into it – every bit of energy and ambition and natural ability you have.”   – John D. Rockefeller, industrialist

Effective Delegation

April 18, 2011

Effective delegation benefits you, the business owner, as well as the rest of the organization. However, when delegating work, I’ve found that asking the question, “Do you understand?” often receives a predictable “Yes,” even if the person does not understand.  So now I ask, “Any quick thoughts on how you plan to proceed?”   The response to this question tells me if my direction was clear, while reinforcing the expectation that their personal initiative is valued.

– James Van Handel, CE Power Solutions of WI, Appleton, WI

What tips do you have for effective delegation?  What works best for you?  What have you tried?


April 14, 2011

“If I had to select one quality, one personal characteristic that I regard as being most highly correlated with success, whatever the field, I would pick the trait of persistence.”    – Richard DeVos, Amway Co-founder

The Process of Delegation

April 11, 2011
You Can’t Do It All – Learning To Delegate

There is not a single management skill more critical to your personal and professional success as an entrepreneur than learning to delegate. There is much more to delegating than meets the eye. It does not mean to simply hand out assignments. It is a science and an exercise in understanding one’s self.

Some of us have been lucky enough to find our strengths and at the same time recognize areas traditionally referred to as weaknesses. It takes mammoth strength to let go and say, “OK, this is not my area of expertise and here is where I need help. This is how I will get this help.” Often, there are things we wish we were good at but somehow cannot seem to grasp (not for lack of intellectual ability, but for lack of experience/exposure). We must learn to accept this fact.

In this fast-paced world we live in, we must choose what it is we wish to conquer and what we need to let go of. An artful business person learns what He/She does best and does that to the best of His/Her ability. He/She lives it, breathes it, and sleeps it. It is a passion. The rest can be left to someone else.  Unfortunately, that someone else does not just appear from thin air. Networking or relationship building, is the initial key component of delegating.

You need to determine how your time would best be spent.  The key is to determine what you need to know, want to know, must know, and already know. Keep lists with these headings to remind you of these things. It is a great feeling to cross things off your list.

Becoming an Expert

Jack of all trades, master of none. The old adage holds a lot of weight in today’s entrepreneurial environment. Know what you do and do it the best you can.  Where does your expertise lie?  The areas you aren’t an expert in and don’t want to become one, set out immediately to find these experts you need.  It is important to surround yourself with competent individuals who have complimentary areas of expertise. Choose carefully and wisely and be ready to compensate these individuals for a job well done.

Payment need not always come in the form of dollars. Remember your area of expertise and be ready to trade it for what you need.  When bartering you need to follow a few simple rules: be nice and respectful, send thank you notes, and recognize those individuals who have helped you both publicly and privately. In doing so, you will gain respect and be known as someone who gets the job done.

When you are an expert, people will come to you in need of your talent. Be prepared to use it. Be proud of your skill and share it.

The Power of Delegating

It is quite liberating once you really do let go and put your trust in other people. The key here is to identify good people, enlist them in your cause or business, give them the ball, and then allow them to run with it. Only you will determine if the ball gets dropped. You must manage and oversee the game on a consistent basis. You must give the right ball to the best possible player.


April 7, 2011

“There’s no great mystery to satisfying your customers. Build them a quality product and treat them with respect. It’s that simple.”   -Lee Iacocca, executive

Definition of Delegate

April 4, 2011
I am preparing some articles on delegating and delegation, and decided it would be best to first get a clear understanding of the definition before we discuss the subject in depth.



1 :  to entrust or transfer (as power, authority, or responsibility) to another: as a :  to transfer (one’s contractual duties) to another b :  to empower a body (as an administrative agency) to perform (a governmental function)
2 :  to appoint as one’s representative intransitive verb :  to transfer responsibility or authority
 entrust, assign, transfer