Why Is Your In-house Medical Billing Staff Unhappy?

by | Published on Nov 14, 2013 | Medical Billing

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When it comes to reimbursement benefits, accurate and timely medical billing is necessary so that you can avoid clashes with payers. With many healthcare providers having adopted the new ICD-10 coding system before the official October 2014 deadline, billing staff is also required to update their knowledge about the new coding system. The pressure of existing work and the new requirements can really affect the functioning of your in-house billing staff. This holds true whether you have separate billing staff or have assigned the work to your office staff.

Here are some reasons why your internal staff may be unhappy about the working condition at your practice.

  • Work all the time – When you are away for a vacation, your medical staff such as nurses are relieved of heavy workload since most of their work is patient-driven or physician driven. But that is not the case with your medical biller who has to work constantly all the time at your office checking insurance claims, battling with insurers, sending medical bills and medical records, answering calls and so on.
  • It’s all in the hands of your medical biller – It’s your biller’s responsibility that you get the reimbursement benefits for the services rendered. It means when the medical bills hit the biller’s desk, he has to check for any missing information and errors. Most often the missing information is the updated insurance related data. With the entry of EHRs, billers have to hunt for missing data such as incomplete notes within the electronic records. Sometimes the biller has to wait for the EHR until the physician and nurses complete the electronic notes.
  • Waging “war” with the insurance company – Another reason why your biller may be rather frustrated is that he might have engaged in a “war” with an insurance company. This happens when a biller normally calls an insurance customer service representative to verify the status of an unpaid claim. The rep assures your biller that the claim will be processed in 10 to 15 working days. If the check is not received within the assured time interval, your biller calls again and this time another rep may take the call and claim that they have neither record of the medical claim being received nor any previous calls made by the biller. The wait time at the insurance company is much longer now, causing major delays in payments and making your clients unhappy.
  • Not getting the help they need – Since you and your medical staff are busy with patient care, your biller may not be get enough help when it is needed. This can affect the billing process and the revenue stream of your practice.
  • More responsibilities than actually assigned – Medical billing specialists cannot be expected to handle medical coding too, though they should have some basic awareness. So if your billing specialist is doing coding too, then that means he or she had way too much responsibility. Coding tasks should be assigned only to AAPC-certified coders.

If your billing staff is not happy, this can reduce their efficiency and affect your the revenue of your practice. Why not let your office staff focus on other core aspects of your business? It is best to leave complex tasks such as medical billing and coding to professionals in the industry. Partner with a reputable medical billing company that has the right resources including professional billers, excellent infrastructure and state-of-the-art medical billing software to provide you the best services.

Rajeev Rajagopal

Rajeev Rajagopal, the President of OSI, has a wealth of experience as a healthcare business consultant in the United States. He has a keen understanding of current medical billing and coding standards.

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