And strategies to keep your billing in tip-top shape. by Melissa Jacobson, RevCycle Partners Operations Manager
Are you concerned about the state of your eyecare practice's finances? Is your biller doing the work they were tasked with? Are they falling behind on accounts receivables (AR)? Could there be money on the table waiting to be claimed?
These are vital questions every eyecare practice owner should ask.
Efficient billing management is essential for your practice's financial well-being. However, it's easy to overlook subtle signs of trouble. Drawing from my years of experience, including a stint as the COO of a ten-location optometry practice, I've learned to recognize signals that billers might be falling behind.
Here are four signs to watch for, along with proactive strategies to ensure your billing process remains in tip-top shape:
1. Growing Accounts Receivable
Sign: One of the most significant red flags signaling a billing issue is a steadily increasing accounts receivable (AR) balance. If you notice this trend, it's time to investigate.
Strategy: As a practice owner, regular reviews of your practice's AR reports are essential. Pay close attention to the aging of unpaid claims, particularly those over 90 days old. If you spot significant dollar amounts in this category, it's time for action. Engage with your biller to understand the reasons behind the growing AR balance and collaborate on a plan to address the issue effectively.
2. Aging Claims Over a Year
Sign: Claims that have languished for over a year should raise a red flag. Such aging claims may indicate that your biller is not effectively following up or resolving issues with insurance providers.
Strategy: Initiate a conversation with your biller about these aging claims. While valid reasons may exist for such delays, your biller should be capable of explaining each case. For instance, perhaps they've appealed a denial and are awaiting feedback. The key is to be aware of timely filing deadlines for various insurance providers, as claims typically need resolution within a year. Investigate and address any unresolved claims promptly.
3. Lack of Posting Explanation of Benefits (EOBs)
Sign: Occasionally, billing departments overlook crucial tasks like posting Explanation of Benefits (EOBs) or failing to reconcile bank deposits with your practice management software. Billers may skip EOB postings or reconciliation due to the complexities of managing numerous EOBs, high workloads, or occasional oversights.
Strategy: Ensure that your biller consistently posts EOBs and reconciles bank deposits with the corresponding payments in your practice management system. This proactive approach helps identify discrepancies and ensures that all payments are accurately accounted for.
4. Claims Not Being Created
Sign: In some cases, claims may not even be created or submitted, resulting in lost revenue.
Strategy: Implement safety net reports provided by your practice management software to verify that all services provided during exams result in corresponding claims. Regularly review these reports to ensure no claims are being overlooked or missed. Establish processes to ensure that claims are created promptly.
Despite your best efforts, internal billing challenges persist. These challenges may include a consistently growing backlog of unresolved claims, recurring billing errors, or insufficient resources to manage billing effectively.
If you consistently encounter billing issues and suspect your in-house billing team may not be performing optimally, consider outsourcing your billing. Third-party billing services offer expertise, accountability, and a fresh perspective. Outsourcing can provide the necessary distance to address billing challenges objectively.
Maintaining effective billing practices is crucial to sustaining a thriving optometry practice. By recognizing these signs and implementing proactive strategies, you can ensure your billing process remains in tip-top shape, safeguarding your practice's financial health.