August 1999 Bulletin

It pays to let computer do the work

Staff can be better used in collecting delinquent claims

By Rosemarie Nelson

Your most valuable resource is the person-time in your practice and how to retain the value of that time is critical to the successful operation of your medical practice. Your medical practice management system can increase productivity by reducing time spent by your staff on manual billing, processing hard copy claim forms, computer operations tasks like printing, manual payment posting, and redundant record keeping and tracking.

Does your staff spend time reviewing patient statements prior to mailing them? The features and functionality found in most computer systems support statement options such as suppressing the printing of statements that fall below a certain dollar amount (it is not cost effective to produce and mail a patient a statement that falls below $5) or suppressing the printing of statements for specific coded billing options. Set up these practice parameters in your system profile and you'll find you print and mail less statements.

In most cases, it is more cost effective for the medical practice to outsource the statement printing and mailing function entirely, thereby freeing up staff to perform other tasks such as collection follow-up that will increase the cash flow into the practice. Statement processing and outsourcing firms can provide services independent of your practice management system vendor, or these services may be available from your practice management system vendor. When providing you with cost information, the outsourcing firm will provide a cost-benefit analysis to demonstrate your savings by outsourcing, based on your specific volumes and activities.

Payments arrive faster with electronic claims submissions and staff time spent handling the paper claims and mailing them out is an additional labor cost to the practice. (Paper claim handling costs approximately $3 to $6 per claim and Electronic data costs are approximately $1 per claim.) A better return on that investment is for staff to be on the telephone trying to determine why specific claims have not been paid. If staff spends two- to three-hours per week printing and processing paper claims, and, instead, spends that same time on the phone contacting insurance providers about outstanding claims, the payroll costs are unchanged, but the practice will realize an increase in cash flow on collected claims of anywhere between $600 and $12,000, depending upon average dollar value of each claim.

Electronic remittance processing saves even more time, which translates to even more money, or money better spent following up on delinquent accounts. In fact, one practice of four physicians recovered over 16 hours of person-time per month manually posting insurance payments. With electronic remittance, the staff has an extra two-person days each month to telephone insurance provider relations staff to investigate unpaid claims. Contact your largest payers for their remittance processing requirements and/or start with your practice management system vendor to determine if additional modules are needed to initiate electronic remittance transactions.

Exploit the patient appointment scheduling features in your system. Electronic appointment scheduling allows you to schedule appointments at any workstation on your network, whether the PC is located in the business office or at the nursing station or at the front desk. Decentralize scheduling and encourage the nursing staff to schedule follow up visits. Relocate the incoming phone calls to a scheduling workstation away from the check-in window, instead of to your receptionist staff who need to focus on greeting your patients face-to-face and welcoming them to the practice.

Use your system to schedule and track referral appointments, revisits, rechecks and annual return visits. Do not rely on your patient to call in for their annual visit. If you tell me to call in three months to make a return appointment, I'll probably take longer to call, or once I do call, it is more than likely that I won't get in for several weeks after the designated time. That is lost or delayed revenue. Do you want your patients to have control of your revenue?

If staff in the practice are not fully utilizing existing features and functionality in the information system, the missed opportunities are reduced collections, ineffective information analysis and evaluation for strategic planning, and few practice promotion activities to referring practices and their staffs. The risk is a loss of potential revenue and even the viability of the practice is at stake. Invite your information system vendor into your practice for an onsite consultation and ask the tough question, "What are we not doing, that we should be with this system?"

Rosemarie Nelson is a health care information technology consultant in Syracuse, N.Y.

Computer Link welcomes suggestions about future topics for the column and questions about the use of computers in orthopaedic practice. Send your suggestions to the Bulletin at AAOS, 6300 N. River Rd., Rosemont, Ill. 60018.

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