Q&A: Tips for bringing billing in-house

October 17, 2008

Bringing billing in-house presents myriad challenges to ensure that old accounts receivable do not get lost in the transition.

Our neonatology practice historically has used a billing service that was adequate. Recently, however, the service was bought out by a larger company, and we have had numerous problems that the service seems unable to resolve. We have decided to bring our billing in-house and have hired a billing manager. What do we need to look out for during the transition?

We could write an entire article on the nuances of the transition you describe, but much depends on the cooperation of the billing service and compatibility of your new software to the old system. Here is a short list of things that are important:

•A printout (or electronic copy in Excel or other universal file format) of the aged, debit, and credit accounts receivable-separate reports to show your true accounts receivable, so you can resolve any credit balances in a timely fashion. These should be organized by payer classification, with enough detail so that you can rebill any outstanding claims from your old system if a detailed transfer of information to your new billing system is not possible. Pertinent details include patient name, ID number, CPT and ICD-9 codes, provider, date of service, date of filing, portion that is the patient responsibility, portion that is the insurance responsibility, what is outstanding on the claim, etc.

•A decision on who will handle the old accounts receivable. When current business is pulled from a billing company, there is little incentive for that company to aggressively work the old accounts receivable. If you decide to bring the old receivables in-house, you need to allocate enough members of your staff to be able to work on them.

• Make sure adequate staffing is in place to handle patient inquiries, claims processing, post payments, and the numerous other tasks related to billing, along with the policies and procedures related to billing accuracy and compliance.

•Resource books such as CPT, ICD-9, Healthcare Common Procedure Coding System, etc.

•Set up phone numbers specific to billing (perhaps a toll-free number) so your normal office numbers are not overwhelmed by billing calls.

The author, vice president of operations for Reed Medical Systems in Monroe, Michigan, has more than 30 years of experience as a practice management consultant and is a certified coding specialist, certified compliance officer, and a certified medical assistant.