Why should you outsource?
There are many situations that yield the decision to keep your billing in house, but there are also many attractive reasons to consider outsourcing your billing to a qualified billing company, like Comprehensive Medical Solutions, Inc. (CompMed).
Human Resources Management
A significant number of practices do not have an HR Manager. This task usually falls on the already over-burdened Office Manager or practice President. Office Managers do a pretty good job of on-boarding new hires with respect to payroll forms, but a lot of times, quite frankly, there are just some required HR items that are not getting done. Either because the Office Manager doesn’t know it needs to be done, which is usually the case, or there is just not enough time in their day to complete all of the HR tasks, and some essential HR functions just fall by the wayside. For example, most practices do not know that reporting new hires to the federal and state governments is required, and this could cause some potential problems for the group. This reporting is easy and free, and to mention again, required! The federal government requires every employer to verify within 3 days of the employment date that an individual is authorized to work in the United States. This is done by asking the employee candidate to complete an I9 form and providing the necessary identification documents. We have found that the I9 form gets processed and filed, but the online reporting on the eVerify portal does not get done. This is the quickest and easiest way to verify that an individual is authorized to work in the United States. If an employer is found to have employed an illegal worker, the first offense can range from a fine of $250 to $2,000. Employers are also required to report new hires to the State in which the employee will work, this is also done online. The State reporting deadline time frame varies by state.
Another HR item that we find lacking in an in-house practice is an Employee Manual. This is absolutely essential to help a business run smoothly. Not only are you relaying the details of general informational items such as when holidays are, when payday is, or what benefits your practice offers, you also establish the rules that employees are expected to follow and what the consequences are if they are not followed. It is important to establish what behavior will not be tolerated, such as absenteeism, harassment, and, for example, what your social medial policy is. Social Media is an integral part of our everyday lives nowadays, however, in a medical practice, we are bound to protect patient identifiable and clinical information. You must establish policies and address how employees engage with Social Medial when your practice is involved. And how to handle Protected Health Information (PHI) must be clearly defined. Having an Employee Manual reduces the time you have to spend on employee behavioral issues, plus reduces potential cause for legal concern – on the employee’s part and on the employer’s part.
Benefit management takes an enormous amount of time to process. Not only from obtaining quotes to make sure you are getting the best deal, but enrolling existing and new employees on the policies is very time consuming as well.
And let’s face it, managing employees can be a real headache! It is time consuming at best, and can be frustrating at worst. If you desire, CompMed can take this burden and manage some or all of your employees, which will free you and your Office Manager up to focus on your main priority: patient care.
These are just a few of the HR items that CompMed finds that are not being done internally in a medical practice. At CompMed not only do we have or do these items for our own company, we assist practices with the development of these items for their own use. We are able to provide this very important role to our clients.
Over-worked Office Managers/Staffing
Office Managers are the unsung heros of the medical practice. They really are expected to wear a lot of different hats. It seems though that being responsible for every little thing is sometimes not such a good thing. When you are running errands or ordering office supplies, it takes away that time that can be (should be) focused on the business office. At CompMed, whether we acquire some or all of your business office/billing employees, our job is to focus on the billing. We can assist your Office Manager by freeing up his/her time so that they can focus on other essential practice tasks that are required for patient care. We’ve also found that this can be a big morale booster too. Over-working your staff can lead to burnout and turnover, both of which create additional expense for a practice. CompMed can alleviate this concern if you outsource your billing to us.
Compliance Plan and Business Code of Conduct
Do you have a compliance plan? Do you have a Business Code of Conduct? Most in-house managed practices do not. The Business Code of Conduct says that we are committed to conducting business in an ethical and honest manner and within the bounds of the law. The Business Code of Conduct is intended to provide employees, contractors, Business Associates, and other entities with guidelines for conducting business in a manner which fulfills that commitment – like submitting only correct claims. The Compliance Plan, coupled with the Code of Business Conduct, establishes a tone for conducting business ethically as well as reinforces commitment to integrity. The Compliance Plan provides a basis for us to implement the Code Business of Conduct.
Why do we have to have a Compliance Plan? Because the gov’t says we have to. The Office of the Inspector General (OIG) has published specific written guidance for many types of entities: Hospitals, physician groups, billing agencies, etc. Because there is written guidance, we are expected to follow the rules. Not only does having a Compliance Plan mitigate penalties, it is the right thing to do, we really should strive to submit correct claims the first time. Having a compliance plan is like having a road map or a tour guide book. It tells you how to get to where you are going – it is formal written plan of how we will conduct business and follow the law. You can rest assured that when you outsource your billing to CompMed, we will follow the law. The benefit is that we can bill more efficiently, staff is better trained, together we can actually reduce denials from occurring, which will mean payments will come in quicker for your practice.
Certified Coders/Auditing
How much of your staff do you devote to auditing? Most practices do not allocate any staff to auditing, and this really goes hand-in-hand with the Compliance Plan and Business Code of Conduct. If you don’t have a Compliance Plan, you are probably not auditing either. You have heard the saying, ”If it is not documented it wasn’t done,” but you would be surprised at how many provider’s documentation does not support the level service they said they rendered. The charge is either over code or under coded. It is important to constantly preform pre- and post-audits. A pre-audit is reviewing the documentation before the claim is filed, a post-audit is reviewing the payment after the EOB is received. CompMed employs coders who are certified by the American Academy of Procedural Coders (AAPC), Radiology Coding Certification Board (RCCB), and American Health Information Management Association (AHIMA). Outsourcing your billing to CompMed means that certified coders are coding your work appropriately the first time, the correct and accurate CPT is assigned, and that appropriate auditing work is simultaneously being performed as well. This is attractive because you are assured that your claims are being filed correctly and that the payments you are receiving are accurate, and timely, as well.
Analytics
When we do a practice review, it is surprising to find what little basic information is being provided to the practice owners. CompMed has a report module with over 200 standard reports but we also use Business Intelligence custom report writing software. We have found this to be invaluable to the practice owners. Not only can we address each client’s specific reporting needs, but we can drill down to the minutest of details. We have found that practices just using canned reports from their EHR software is not sufficient to manage their practice. Having these details allows a practice to determine if it is necessary to hire another practitioner, the appropriate amount of clinical FTEs to employ, or to perhaps evaluate a certain service that is either not bringing in enough revenue or has high associated expenses. We are very surprised at how little practice owners really know about their practice metrics. CompMed provides this detailed reporting, but we also combine this with the financial/accounting reporting. CompMed has dedicated folks who will supply this information to you, so that you will know exactly where your business stands.
Staffing the Business Department Appropriately/Technology/Days in AR
These three things really go hand in hand. We have found that while the clinical area is staffed appropriately, or sometimes overstaffed, the same consideration is not always given to the business office/billing side. A lot of practices tend to shave FTEs in this area. And we get that. Providing patient care is why you exist. But if you don’t have an appropriate amount of employees to file your claims and collect balances due, then the practice will not receive appropriate revenue to exist. CompMed staffs our business office with an appropriate amount of FTEs to perform every billing function. And we do this by engaging with highly advanced billing software. We make the computer work for us so that employees can focus the majority of their attention on resolving balances due. And then this naturally yields lower Days in AR, higher payments per CPT, and more income to the business owners. As equally important, outsourcing your billing to CompMed allows us to reduce your billing expense: an appropriate amount of staff at less cost to you bringing in more dollars is always desired and appreciated.
Balancing and Reconciliation
One of the areas we find that an in-house practice does not do is they do not balance payments posted back to the bank deposit made. Surprisingly, it’s just not thought of to be done. The thought of connecting the posted transactions in the billing computer with the bank account is just overlooked. This is an essential basic accounting function and its importance simply cannot be undervalued. These functions should be separated: the employee or employees who post payments should not also be the same employee or employees who handle the bank account. In many many practices, this is the same employee. When you outsource your billing to CompMed, we separate these duties to provide financial integrity and accountability, down to the penny, and we also provide the financial reports where you can visibly see this reconciliation. It is another tool for CompMed to help you analyze and manage your practice.
Time and Expertise
One of the most compelling reasons physicians outsource their billing to CompMed is because: they didn’t go to medical school to be a business manager. Managing a business is a full time job in and of itself. You already have a job, you’re a clinical practitioner! Most physicians find it overwhelming, and really exasperating, to perform clinically and provide patient care while simultaneously managing employees, a business, and the billing process. There is just not enough time in the day. No one person can be an expert in everything. At CompMed, we use a team approach. We employ many individuals who are individual experts in all of the areas previously mentioned. There really is power in numbers. CompMed provides the depth of knowledge, expertise and know-how where it is missing in your practice right now.
If you are considering outsourcing your billing or if you have questions, please contact Angela Patterson at (423)903-6796 or angela.patterson@compmesolutions.com. We will be happy to discuss how our business can be your outsourcing solution.