Wednesday, September 17, 2014

Well-Communicated Office Policies Save Time and Prevent Avoidable Interruptions for Doctor's Offices

Too often, busy medical practices forget to connect and communicate with patients in a meaningful way that can lead to a much better patient-physician relationship, especially in regards to payments and obtaining lab results or medical records.

Patients want and need to know what your expectations of them are. They want to have a connection with your office and to be able to communicate with you in an effective way. Being proactive by providing concise policies upfront can improve patient relationships as well as reduce time spent on avoidable and costly issues.

Traditionally, physicians have spent little time communicating with patients outside of office visits. However, offices can make positive significant changes that will enhance the value of the practice to the patient while improving communications with clear office policies that ultimately improves your collections.

For some, a patient's only means of communicating with their healthcare provider is over the phone talking with a staff member or during an office visit. Unless a practice specifically communicates office policies or test results, patients often have to call their doctor's office. Communicating office policies on obtaining results can prevent unnecessary phone calls and wasted staff time.

If you take the time to provide all the necessary information to patients, along with your expectations from the beginning, your practice will operate more efficiently, requiring fewer phone interruptions and easily avoidable problems that can be a drag on practice income and employee morale.

Although this is far from a complete list, here are some policy examples you may want to communicate to patients:

• Requirements and importance of maintaining current account information (address, insurance, responsible party)

• Types of payments you accept (cash, credit cards, checks) by fax, mail, website options

• Returned check fees

• Obtaining medical records and fees

• Billing cycle information

• Hardship discount application and documentation

• Services for minor children (who is responsible, who can obtain records, etc.)

• Delinquent accounts

• Missed appointments

• Hours of operation

• After-hours and on call coverage

• Referrals and or forms completion

• Billing inquiries

• Self-pay accounts

• Secondary claims filing

• Circumstances for discharged patients (delinquent or not following doctor's advice)

• How codes for visits are selected based on AMA guidelines

Patients don't like surprises anymore than doctor's offices do. Provide patients with the information they need to know up front and regularly. Refer them to the information when they have questions. Otherwise, you'll spend a lot of valuable time and effort explaining things and preventing unnecessary disruptions to your practice. This also prevents patients from doing an end-run to the doctor asking for discounts and freebies - he/she can simply refer the patient to the office policies.

Certification Needed to Work in Medical Billing

Often, people asked whether or not a medical biller is required to be certified in order to be a medical biller.

While certification is not required yet, there are some very good reasons why one might want to obtain certification.

The main purpose of certification is to promote ethical and professional Medical Billing through certification of qualified individuals by formally recognizing proficiency demonstrated by having passed an exam, encouraging continued professional and personal best development and providing a national standard assessment based on industry knowledge. Certification demonstrates to physicians, employers and others that you have taken proactive steps to advance your education, knowledge and skills.

Currently, there is no Federal requirement for certification, however, the state of New Jersey does require third party billers to comply with their "certification" process.

At some point, as defined by the Health and Human Services Secretary (Secretary), billers will be required to register with the state and the Secretary under Section 6503 of the Affordable Care Act.

    provide that any agent, clearinghouse, or other alternate payee (as defined by the Secretary) that submits claims on behalf of a health care provider must register with the State and the Secretary in a form and manner specified by the Secretary

For now, billers can safely process claims without registration or certification, unless you bill for healthcare providers in the state of New Jersey.

Being required to obtain certification and wanting to obtain certification are two very different things -- many billers want to get certified to demonstrate their proficiency and professionalism to doctors and other healthcare providers. It demonstrates commitment and dedication in providing the highest standards possible in Claims Management and Medical Billing.

Certification typically requires continued education to maintain the credential and demonstrates to others that you will continue your education process by taking steps to improve your value to the industry and the doctors you work with.

More and more physicians and other healthcare providers are looking for certified professionals that understand regulatory and business issues that affect their practices. Certified billers typically have the knowledge, skills and confidence to be more effective in increasing revenue, preventing fraud and abuse and researching and finding information that helps practices succeed in today's environment and economy. As healthcare providers and doctors begin to require certification from employees that expect a pay raise, more billers will become certified and eventually, it will become the standard for our industry.