Tuesday, November 30, 2004

Cut costs, not quality
with Esther Apter

Q. How can I prepare for reimbursement cuts without sacrificing the quality of collection activity?

A. To increase efficiency without adding staff, start by evaluating the current effectiveness of the billing and collection activity. Monitor the quantity of work produced by each employee in billing and collections. Count how many claims are produced daily, primary, secondary and tertiary. Compare the results by employee to create a benchmark for evaluation. Use that benchmark to create goals to increase the quantity of work being produced. Evaluate the procedures of the employees producing the most work and streamline the process so all employees can obtain the same goals. Last but not least, evaluate procedures. Determine what’s slowing down the process. Are people spending too much time searching for backup documentation to appeal a claim? If so, evaluate your filing system and research ways or technology to improve and enhance the system. Are people spending too much time on hold with insurance companies? If so evaluate your top 10 insurance companies and see if you can status claims on line to speed up the process. For insurances that keep you on hold and let you deal with two or three cases in a call, make sure people are preparing the two or three cases for one call to minimize the hold time.

Esther Apter is the president of Healthcare Management Solutions: