Take a consumer-oriented approach to your billing cycle

September 11, 2020
Jordan Rosenfeld

The three main areas where physicians can focus their billing practices.

The Covid-19 pandemic is transforming how physicians practice medicine and bill for it. Physicians who take a consumer-oriented approach to their billing cycle may adapt the best, says John Behn III, MPA, president of Stroudwater Revenue Cycle Solutions and a principal of Stroudwater Associates, a national healthcare consulting firm based in Portland, Maine.

“We’ve seen a lot of practices become very entrepreneurial about how they see this new process through the patient’s eyes,” Behn says. The practices that will thrive, he says, are those that are trying to find ways to make the billing process as easy as possible for the patient as possible, and as streamlined in the workflow as possible.

Behn feels there are three main areas where physicians can focus their billing practices with patients in mind right now.

Communicate with patients

Now is the time to improve communication with patients, Behn recommends. This means making sure the appropriate staff are available to handle and answer patient questions quickly and efficiently.

“You’ve got all these patients with comorbidities that are not sure how to make contact with their physicians or if they should go to the ER,” Behn says. Physicians can help alleviate patient anxiety by reaching out and explaining everything from billing procedures to advice. Additionally, older patients may be struggling to adapt to the technology necessary for video calls, and may need to be coached or supported through phone calls.

He also recommends having strong referrals to the right kinds of specialists so that patients continue to feel that they are getting the level of quality care that they get at their primary care office.

Additionally, he says, physicians have to “keep an eye on tomorrow, because eventually things are going to rebound and get back to normal.” He urges physicians to identify patients in several tracks—such as a COVID track, and a chronic care management track—to know who will need to be rebooked most immediately when in-person appointments can resume.

“You can commence the longevity of your practice by making sure that patients feel as though you’re a better resource than calling anybody else,” he says.

Stay up to date on the changes in the marketplace

From the back-end, Behn says, physicians help their patients by staying on top of the guidelines coming out of the Centers for Medicare and Medicaid Services (CMS), state Medicaid and even big payers.

For example, to accommodate an almost overnight shift to largely tele-health clinical visits, CMS has waived some older guidelines on how these visits can be billed, Behn says. This offers more opportunities for physicians to bill, but can also be overwhelming and comes with numerous changes.

“You’ve got physicians who theoretically have never even had access to or had a reason to use these codes. Now all of a sudden this full compendium of services is available, but CMS seems to be changing things daily.”

Some of the billing changes are retroactive to early March, Behn says, which can cause problems. “Now you’ve got the need for your billing staff to go through and rebuild claims so you can get better and more proper reimbursements.”

He recommends physicians make sure that someone in the practice is dedicated to keeping up on this information. “It doesn’t matter if you’re the greatest doctor in the world; if you use the wrong code, you get nothing.”

Pay close attention to claims

This unusual time in practicing medicine “is an opportunity to critically examine your revenue cycle foundation and correct the inefficiencies,” Behn says. “If you’ve got best practices employed, what’s happening now is challenging those foundational elements. But if you had a lot of inefficiencies, this crisis is augmenting those.”

Behn recommends physicians “Watch your billing clearinghouse like a hawk,” and “make sure your system is set up to reflect the best thinking and guidance from Medicare, Medicaid and commercial payers.”

Not only does preparing strong claims and reviewing them closely increase the amount of revenue coming in, it prevents problems with patients bills, making sure they are only paying as much as they owe, Behn says.

“You can’t afford any denials.”