How to Make Sure You Keep More of Your Money

I’ve mentioned in the past that there is a great resource I recommend for current practice knowledge and chat- it is Physician’s Practice, which you can find at www.physicianspractice.com.  It doesn’t cost anything to sign up there, but it is well worth it for the office and coding tips and tricks alone.  I noticed a theme over the last month or so in their Practice Pearls e-mails and pulled a bunch of collected office wisdom for you.  I will post the articles I used at the end so you can go read them in their entirety.  Some come from this year’s MGMA conference in San Antonio, TX where they collected some current thoughts and discussion on meaningful use and best office practices.  This is all new and current stuff.

First off – Verify, Check, double-check, and Confirm.

We’re mostly talking about insurance here, but you should do this for all of your patient info.

• Does the patient’s name and spelling match the information on their a.) Driver’s license/id card, b.) Their insurance card.  I would add did you photo copy it and add it to your PM or EHR (so you have it for re-check and confirm later too).
• Have you checked and confirmed the patient’s date of birth.  Did they accidentally put today’s date or year on there because they were new and nervous?  Does it match up with their driver’s license/id?
• Did you confirm the insurance subscriber for each policy the patient has?  If the policy is not their own, do you have the policy holder’s correct name, spelling, date of birth, and SSN# (if needed)?
• When a patient calls in and you ask for their policy #, are you verifying it right then? They may not know what number(s) on their insurance card you may want and may give you the wrong number(s).
• Out-of-pocket and Deductible charges info do you know what it is for your patient and have you verified and noted it? Odds are that your patient will not know for sure and even if they think they do, you need to verify, if you want to get paid.
• The insurance claims address.  Have you verified where you need to send the patient’s claims?  Often the address isn’t on the patient’s insurance card or there is only a phone number.  If you don’t already have the insurance company’s claim address and phone number in your system, take time to put it in there and verify it.

Physician’s Practice article:  “Verifying Patient Health Benefits a Must at Your Medical Practice”, by P.J. Cloud-Moulds, October 13, 2012.

Secondly – Some expert advice given at the MGMA session this year.

• As a small to mid-size practice, if you are not currently working on or preparing for a “value-based” reimbursement system you will not only be behind, you might lose out.  With Meaningful Use in full swing and insurance companies following the same ball, you are behind the times and headed for payment trouble soon if this is not on your agenda.
• Better physician production- this would include inefficiencies in scheduling, coding instruction & training, etc.
• Improved practice efficiency- this would include inefficiencies in training (coding and insurance handling in particular), making patients aware of your office’s financial policies and everyone in the office following through.
• Make everyone in the office responsible for revenue.

 Find ways, take time, and make sure that everyone in the office has a clue about how insurance information and billing fit into your office.  One of the best suggestions I’ve seen is to have billing and front desk switch up and or work together for a couple of weeks.  That way front desk knows the what and why of the information they are gathering from the patients so they understand their part better.  Having your biller work up with your front desk people can help them to aid you in identifying and streamlining your information intake.  By the same token having any of the doctor’s scribes and even the doctors work back and forth with your billers and coders and bit, can help streamline and strengthen the accuracy of the coding and billing data you get from that end too.  If more people are in the know, it will be easier to make everyone responsible for the revenue.
A lot of this comes from the Physician’s Practice article:  “How to Boost Your Medical Practice” by Aubrey Westgate, October 16, 2012.

Thirdly – Embezzlement.  You need to watch your money coming and going, all of the time.

Unfortunately embezzlement occurs because of trust.  Ok, trust without checks would be more accurate.  You have to be your own first and last line of defense; you cannot delegate some important things in your office if you want to be able to keep track of your money.  Are you checking your Bank and Credit Account for proper reconciliation (i.e. do your money comings and goings match up to your records)? 

• The suggestions, to keep this information coming to the source so it can be checked, are that all incoming Bank and Credit Statements should be mailed to the Doctor or Owner’s house, should be handed, sealed to the same, or best yet, the owner directly accesses the information via the financial institutes website. 
• No one person should have sole access to give out/take from any payroll, petty cash, or general operating accounts.  They should always require 1-3 authorized signatures.  Best bet, one of them is yours Doctor/Owner.
• I really liked one of the comments left with this article, by Carol Stryker:  “Independent verification.  A transaction is most vulnerable before it has officially been recorded.  Copays and deductibles collected at check-in are good examples because a receptionist can simply pocket the cash without recording the payment… My preference is to have one person collect the copay and another post the payment.  One way to achieve the separation is to have the front desk receive the copay or deductible, prepare a receipt, and attach the receipt to the super bill or give it to the patient to present at check-out.”

I really like the idea of giving a receipt, especially if it is documented in your system so it shows up on your incoming money for the day.  Not unlike many fast food joints – you might want to post and encourage your patients to let you know if they don’t get a receipt and maybe keep some small gift cards in your drawer for if it ever occurs.  There will be slips ups, we are all human, but this is a way to maintain a constant double-check and it helps to keep everyone vigilant and honest in your office.

A lot of this comes from the Physician’s Practice article:  “Medical Practice Embezzlement:  Key Accounts to Watch” by Carol Stryker, October 12, 2012.