Bill Sample / December 10, 2018 / Inez Nielsen
Useful metrics must be comprehensive and simple. They must combine both complete end-to-end processes and their individual components. Metrics must be used consistently over time and compared to standards. Obviously different standards apply to different medical specialties patient demographics payers and samples of CPT codes. Medical billing metrics typically include compliance cash balances charges accounts receivable and collection ratios to help monitor cash flow. This article focuses on performance metrics. For discussion of compliance program see companion article on Medical Billing Compliance. Collection Ratios Traditional metrics include gross and net collection ratios. Both metrics are subjective to individual practice because they compare (often arbitrary) charges to (allowed) payments.
The same can be said of a sample contract. If nothing bad ever happens the sample contract is fine. But if a problem occurs it may not work out so well. When starting your new business no one wants to think about things going wrong but unfortunately in this business things do go wrong and we all need to be covered by a comprehensive contract when this happens. It may not be anything you did wrong and it may not even be anything the provider did wrong but sometimes things happen that are beyond our control. If you do use a sample contract and then two years later find yourself in court with a former client you are going to wish you had looked into writing the contract a little more. Just having a contract doesnt cover it. You need to make sure the contract is very specific to your company.
It is a good idea to try to think of everything that can go wrong in the relationship and write down your feelings about how those situations should be handled. You should be able to come up with a long list. In the circumstances of a new biller it can be difficult to know what can go wrong. It has been sixteen years since we started our medical billing business and we are still learning about new things that can go wrong. Most providers expect to sign some form of contract when using a third party service and generally expect the billing service to produce it. They want to make sure they are covered as well as the medical billing service. Going over the contract with a provider starting out with you can set the stage for a successful relationship. You can go over the terms carefully making sure the provider understands what you need to make it a beneficial partnership. Most of us when we are starting our businesses do not realize how much a good contract can affect their business.