Bill Sample / December 9, 2018 / Ellen Tillman
Billing performance measurement is an integral part of medical practice billing process and a prerequisite to effective practice management. Systematic measurement becomes mission-critical with growth of billing complexity or outsourcing of the billing function. Traditional billing metrics are limited in scope and focus on claim submission process ignoring process imperfections on the insurance (payer) side. Modern computer technologies allow both productive measurement and effective action by the disciplined billing office to improve claim submission and payment processes. Using appropriate metrics helps improve policies and procedures shorten revenue cycle reduce patient complaints improve financial performance and compliance increase cash flow reduce bad debt identify areas of potential growth improve employee morale increase productivity and reduce costs.
This number has improved down to 17.7% in 2004. In summary comprehensive and charge-invariant metrics such as PARBX are more informative and objective than collection ratios. However these metrics alone fall short from identifying specific areas for billing process improvement. Modern technology helps identifying billing bottlenecks as it allows interactive review of multiple metrics along different aggregation dimensions. For instance PARBX metric is especially helpful to identify patterns of problem claims containing specific payer or CPT code. Further modern Vericle-like technologies enable comparison of every payment to allowed amount and subsequent appeal on every denial effectively reducing the average percent of accounts receivable to low single digits.
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.