Guest post by John Squire, president and COO, Amazing Charts.
Why do so many small medical practices give up a significant portion of their earnings to outside billers? Depending on its geographic location, volume of billing, and other factors, a practice will pay an average of seven percent of its total revenue to a biller, which could be the difference between profit or loss, maybe even success or failure.
In many cases, the reasons given are that no one in the office has experience with medical billing and the physician doesn’t believe a small staff can handle the added burden of work. But if you dig a little deeper, these assumptions are often wrong.
As a developer of electronic health record (EHR) and practice management (PM) software for small practices, my company hears a lot about billing directly from physicians and staff. We’ve learned exactly who does the billing and how they do it once a practice starts using a PM system for the very first time.
In one case, a medical assistant was able to learn everything he needed to know about billing from the PM product training alone. That’s because the physician specializes in podiatry, so the practice uses a limited set of billing codes. With a relatively light patient workload, this Medical Assistant has more than enough time to handle billing functions during normal office hours.
At another practice, when a gynecologist questioned her staff, she learned that her receptionist was eager to start doing something else, preferably from home so she could care for young children. The receptionist became certified in medical coding at a local community college on her own time, and now uses the PM system remotely and visits the office once a week every few weeks.
In a third practice we know, the pediatrician himself shares the work of billing with two of his part-time staffers, who welcomed the extra hours of pay. One staffer had knowledge of billing from a past job, while another was eager to learn. They all handle billing together as a team, so there’s no burden on any single person.
What allows these “novices” to take on billing is PM software that can make the staff more productive through electronic automation of repetitive tasks, such as submission of claims. Also, having EHR and billing systems seamlessly integrated means that clinical documentation translates directly into billing data, eliminating the curse of having to enter information into two systems.
Every small independent practice that uses an outside biller should ask the following questions: Do we use a relatively small number of ICD-10 billing codes over and over? Are any of our staffers looking for new career opportunities? Do any of our part-time employees want more hours and would they welcome billing work?
If the answer to any of these questions is “yes,” then billing in-house is a definite possibility. As we’ve seen, practically anyone can do billing with a little training. This includes practice managers, receptionists, medical assistants, and even physicians themselves. The truth is that virtually any small practice with a flexible staff can do its own billing with a PM system.