Let’s face it, medical billing is difficult to do well with consistency. However, the practices that do it well have certain things in common. One thing is they all recognize the importance of the front office staff; the “front end” of the revenue cycle, it is often called.
The front-end staff are key to a superior revenue cycle. They control the financial viability and access to the medical practice. They play a key role in obtaining full and complete registration and ensuring payer specific requirements are met. Providers are responsible for coding and documenting their work accurately and supporting the policies and procedures of the practice. The staff and providers who are closest in proximity to where the patient physically receives care, play a vital role in making sure billing goes well by “doing it right the first time”. Devoting the proper attention and resources to front-end billing pays off with higher percentages of clean claims being submitted and paid by payers, resulting in significantly less resources deployed for the back-end billing functions and rework.
It is important for providers and staff to recognize there is a significant cost to the reworking of a claim if the billing and collection process is not performed correctly the first time. In addition to the cost of performing and billing for the service, there is a cost associated with reworking a claim that has been denied. We estimate this cost, including staff time, supplies, interest and overhead to be $17.53 per claim. Needless to say, if the work is done right the first time, your practice is much better off.