Tuesday, January 27, 2009

How To Improve Your Medical Billing in 2009

By Carl Mays II

According to many polls, by January 31, 2009 the majority of New Year resolutions will have already been abandoned. This does not mean that it should be a day of mourning, but rather it is the time to take stock of what needs to be done to reach the goals that were set at the end of 2008. It is critical to keep in mind two of the corner stones for achieving any goal:

1. Treat your set backs as temporary failures and not total defeat (i.e., just because you broke down and smoked a cigarette does not mean you should just say I failed on my goal to quit smoking); and

2. Create a series of intermediate goals between where you are and where you want to be (i.e., instead of "I will lose 50 pounds this year" focus on "I will lose 1 pound each week").

So, this is interesting, but how does it apply to medical billing? Well, if you keep these ideas in mind you can use them to achieve lofty improvements in medical billing performance. How? Start with a powerful and straight forward goal: Make sure your claims are clean before you submit them. This will help your medical billing in several ways:

- It focuses you on the most critical aspect of billing. If the claims go out the door clean you will find that all of the rest of the challenges start to become much more manageable;

- It allows you to focus on achievable, smaller goals (85% of claims go out clean in January, 87% go out clean in February, etc);

- Individual failures (rejected claims), provide fertile learning opportunities for improving your medical billing process. As long as you look at rejected claims with an eye towards how you can stop the rejections in the future and not just with a mind set of how do I fix this individual claim.

- Technology can be a powerful ally in achieving this goal. The use of coding tools, automated demographic verification tools and scrubbing claims will eliminate many sources of up-front errors that lead to claim rejections.

What does all of this mean? It means this is the time for a renewed focus on your medical billing business goals. It is time to:

- Determine where you stand today (what percentage of your claims get paid on the first submission);

- Write down a powerful and meaningful performance improvement goal (my practice will have over 95% of its claims accepted on the initial transmission);

- Break them down into bite size pieces (I will improve clean claim submissions by 2% each month), and

- Develop a process for gleaning learning from claims that do not initially clear the clean claim hurdle.

This approach and focus can allow your medical billing efforts to reach new standards of excellence in 2009.

Copyright 2009 by Carl Mays II - 15485

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