When it comes to collecting co-pays, checking in patients and verifying insurance, the front desk staff has a vital role to play. The front desk also has a role to play in medical billing and collections for the practice. But even the back office does a lot of heavy lifting for billing and collections. So not just front-desk but back office staff also need to be experienced and well-trained.
Here are some of the ways in which providers can get their back office team to bring their best game of collections and medical billing efforts:
It is very important for medical billing services providers to train select employees for setting up payment plans. It happens very often that the front desk staff discovers the need for setting up a payment plan with self-pay patients or patients who have an outstanding balance. But when it comes to the real arrangement, the back office staff does it. It is very important for practices to ensure that these plans are fair for all patients and also consistent. Practices need at least one or two staff in the back office who are trained in setting up the plans correctly. If the back office staff is trained, it will reduce the pressure on the front office staff for making decisions without payment waiver.
Back office staff should also handle the analysis of insurance denials and develop processes required for reducing the denials. They need to see if there is a misuse of modifiers or if denials are related to lack of medical necessity information. Back office staff should be trained in tracking denials and seeing where the practice is making mistakes. This will help them get prompter payments. Also, they need to ensure that all processes are in place for refilling and correcting denials in a timely manner.
It will also help if the back office staff is following up on A/R on a daily basis, running insurance aging reports and reviewing accounts that are at least 60 days old. They may have to contact the payer in some cases because most claims get paid within 21 to 30 days of submission. They also need to conduct the analysis of patient flow on a regular basis because if there are issues with patient flow, then it will cost the practice. Even follow-up on patient balances is necessary.