Bill Sample / December 9, 2018 / Heidi Herring
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.
When we started we used a very simple contract that really didnt cover much at all. When situations arose that were problems our contract was no help. We had to re-write it once we had been in the business for a while and knew what needed to be covered. So where does a new billing service start when they havent been in business long? Its hard to write a contract covering all areas and what to do when you havent experienced it yet. Most new billing services are working on limited capital and dont like to spend money on a lawyer writing a contract for them. Unfortunately many new services cut corners here to save money but thats not a good idea. Your contract should be at least looked over by a lawyer if not written by one. If possible you should try to find a general practice attorney who specializes in contracts.
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.