Home Forums Discussions Coding and Billing Keeping Tabs: Oversight of Medical Billing

So, I'm a family doc in solo practice. I have a staff member who does all the medical billing using Medisoft. I have to admit that I am pretty clueless about what she does, but she's very dedicated/trustworthy and we seem to do fine financially. But now she's getting ready to retire and I'm starting to panic...

I'm hiring a new person to do the billing and realize I really need to get more involved, figure out how to keep tabs on her work and do some oversight. I'm also thinking I might switch over to AC-PM but haven't a clue as to how to decide if this makes sense for us.

I suspect I'm not the only doc in a small office who feels out of touch with PM and wonders how to keep tabs on the billing/coding. Have you got any advice you might share? How do you know if billing and coding are being done well? How can the billing process be overseen to assure that it's done well?

I use an excellent billing company that only charges 6%, takes care of all the PM and collections. I could check and see if they would be willing to take someone form out of state. They do a fantastic job and would probably cost you less as you are solo and should not be keeping a biller that busy.

I have billed in the past, sent to a billing company, and recently brought it back in house.

I hope never again to use a billing company. You need to keep a pulse on what is going on, or have someone you trust to do the same.

I do billing and posting for our practice. The only way for YOU to know is know how to run and read billing reports. For our PM software, I have to run 4 different reports to really cover every single visit and what their paid status is.

The first report is finding all the unbilled charges. We use a paper superbill, which means it can sometimes get lost. This report will display all the visits that have been signed off in AC but has not been billed yet. (When a note is signed off in AC, a "bill" is created in our PM software automatically.) I find at least one of these per month.

The 2nd & 3rd reports are primary and secondary insurance aging. This report shows the "age" of each generated claim that has not been paid yet. I look at the ones older than 30 days. These would then have to be checked with the payers to see why they're not paid.

The last report is called "patient aging." These are charges patients owe, after insurance has paid. Forgot to pay copay, insurance denied the claim, etc.

A note about the ins aging reports. Most of the old unpaid claims are claims that I'm "working" on, whether I had to send a corrected claim or if I'm in dispute with the payer. I keep track of these claims in a folder but having this report is good in case papers go missing or I had forgotten about one of theses claims.

If your PM can run the equivalent of these reports, then you should be able to see how well your practice billing is doing.

Thanks to everyone for your feedback.
Serene, I found your thoughts especially helpful. I'm in the process of switching to AC's PM. Hopefully I will be able to generate the reports I need to stay on top of things.