Doctor, are you constantly asking your staff to show you the money, read on.
A doctor not only treats patients for their various physical needs but runs a business at the same time. Doctors have large overhead expenses. They pay rent, salaries, utilities, medical supplies and many other expenses. They also have to maintain their own private family home and family expenses.
Have you noticed that single practice doctors are now mostly in the past. Multiple doctors networking together is now what is expected. This cuts down on some of the overhead.
Since HMO's and other insurance plans have taken over medical insurance for most people, the medical doctor also has to change. For instance, remember the days when you actually had ten(10) minutes with the doctor. Now you may only have five (5)minutes.
The reason is money. HMO's and other insurance companies have cut the reimbursement to doctors. The doctor has to make up the difference in revenue by seeing patients in volume.
Many older doctors are now retiring thanks to HMO's and other insurance plans. The doctors are confused and angry with the change in medical care. When they went to medical school, it did not include fighting with insurance companies for medical care for their patients.
Doctors do ever wonder why your office is not bringing in as much revenue as it should? Read on.
I worked in several doctors offices over the years and I have been a patient in many. As a patient, I always observe the receptionist. I watch the interchange between the receptionist and the patients as they come up to the window to check in. Is the receptionist courteous and polite to the patient?
RECEPTIONISTS RESPONSIBILITIES:
(1) Be aware of money owed by the patient from a previous visit.
(2) Collect co pays.
(3) Make sure the patient has given you the correct insurance information. Call the insurance company and find out if the deductible has been met for the year or if there is a co pay owed.
(4) If a cash patient make sure you collect the money before the patient leaves the office.
If an arrangement has been made between the office and the patient to pay part now and part later, make sure the patient is well aware of this before they vanish forever into the sunset.
(5) Make a copy of the front and back of the insurance card.
(6) If the patient needs a referral or authorization make sure it is in the chart ahead of time. Going back and trying to get a retro leads to more paperwork and an angry patient.
(7) Make sure you have the patients correct address.
(8) Answers the phone and makes appointments.
RECEPTIONISTS multitask constantly though out the day. They have an important job. They are the spokesperson for the doctor. When a patient checks in or out of the office is when the money is collected from the patient. It can easily be missed.
MEDICAL INSURANCE BILLING:
(1) Send the claim form out correctly the first time to the medical insurance company. Take the time to check it over and make sure all information has been keyed into the computer correctly.
(2) If a mistake was made and you receive and Explanation of Benefits (EOB) back requesting medical records or whatever is needed to get the claim paid, do it immediately. This will cut down on the number of angry patient calls to you.
Billers you may not like the piles of denied Explanation of Benefits you receive back from the insurance companies but they are pure gold for getting the claim paid. The balance is usually the patients responsibility.
THE DOCTORS RESPONSIBILITY:
Sometimes, the workload is so heavy the biller gets stressed and frustrated and feels trapped. When this happens maybe, another person is needed to divide the workload.
The doctor needs to take a good look at how smoothly the office is running. How efficient is the receptionist in multitasking and collecting the money.
The doctors today need to be well informed on medical insurance and the various plans. This way the doctor can treat their patients according to what their medical plan will allow.
If during the doctors visit the patient needs an unexpected procedure etc., the procedure should be authorized with the insurance company before the procedure is performed. By treating the patient before the authorization is obtained, the doctor may not get paid for the procedure.
The explanation of benefits (EOB) from the insurance company will be denied for the reason. Not a covered benefit or no prior authorization.
The doctor must take a more active role in the running of the office and be aware of all the medical billing nightmares that pop up and why they happen.
DOCTOR - FIND THE HIDDEN MONEY SITTING IN YOUR COMPUTER:
Many times there are claims ready to be paid by the insurance company, the insurance biller must be trained to handle problem accounts.
The easiest way to find the hidden money is to run a print out of all your open accounts.
(l) Have they been followed up?
(2) Look at all the Explanation of Benefits denials that are probably stacked on a desk. This is a very good way to get a handle on what is actually happening to your money!
(3) Sometimes, all it takes is an appeal by phone or by letter to start communication once again with the insurance company.
These are some suggestions to look at in finding hidden money. This entire article can start revenue flying into your office.
Sometimes, all it takes is a kind word, a hand shake while saying, "good job" to your staff to motivate them into zoom mode and get the job done!
Today doctors and patients are trapped in escalating medical costs. What do we do about it? How can we change this?
WHEN THE MEDICAL INSURANCE SYSTEM DOESN'T WORK:
We start with the local, state and on to federal government.
EVERYBODY NEEDS MEDICAL CARE! I will repeat. EVERYBODY NEEDS MEDICAL CARE! Did you hear me in Washington. If the system doesn't work. CHANGE IT!
Please let me hear from you on this article or any of my other articles.
If you have a question on your medical bill when you have insurance check out my article listed below:
Horrifying Medical Bills With Insurance! Fight Back!
If you don't have medical insurance check out my article listed below:
When I Don't Have Medical Insurance! What Do I Do?
Everybody is entitled to medical care. Do you hear that Washington. If the system we have doesn't work. Change It!
Copyright 2006 Linda Meckler
I have worked in many doctors offices and what I have written is my observations. I have now become a published author of my first book "Ghost Kids Trilogy" a first of its kind adventure. Love, Family Values, and Charity burst off the pages. This is 3 books in 1 book. For ages 8-14 to adult.(Book 1) Ghost Kids: 2 real children and 2 Ghost Kids team up to get the Ghost Kids back to their parents. (Book 2) Blue Vase Mystery: Uncle Charlie the villain of the book is trapped in a magical blue vase. He wants out of the vase. In return he will tell the children where Pirates' Treasure is buried in their house. (Book 3) Pirates' Treasure-the hunt- Go on a treasure hunt with the children.
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