The TEN Billing Commandments

Be sure to follow these rules if you want to keep your practice on the financial straight and narrow, says Garry Chapman

1 Thou shalt review on a regular basis the way your practice is billing your work to ensure that you are both compliant with the ever-changing rules and regulations from private medical insurers (PMIs) as well as understanding the implications these have on your income.

2 Thou shalt ensure that your practice keeps up to date with the latest Clinical Coding and Schedule Development (CCSD) changes for your specialty and how the respective PMIs deal with those changes.

3 Thou shalt not fail to ensure that you review your fees on a regular basis. This is particularly important if you bill to insurance guidelines, as they are changing all the time. Cigna, for instance, has recently been increasing its fee schedule for its CCSD codes.

4 Thou shalt make sure that your work is in voiced in a timely manner, which will ensure that you have consistent cash flow and will assist with your debt reduction.

5 Thou shalt see that, what ever pricing structure you have for your practice , you make sure it is clear and that your patients are made aware of it before commencing treatment – preferably on a patient registration form.
Then there is no room for ambiguity when it comes to settling the bill.

6 Thou shalt ensure that your practice is chasing any outstanding invoices on a consistent and continual basis in a timely manner until they are paid in full lest you continue to experience a high level of bad debts.

7 Thou shalt ensure your practice is made aware of any bad payers, so that you can decide if you want to continue seeing them while they have out standing invoices.

8 Thou shalt not fail to ensure your practice has management information on where your patients are referred from, as well as what percentage of new patients come from each private medical insurer, self-pay, embassies, solicitors and other payees. This will allow you to make informed decisions about your practice for the future.

9 Thou shalt make sure that you spend as much time as possible focusing on your core skill set – which is treating and looking after the patient to maximise your income.

10 Thou shalt note that if you cannot manage all of the above, then you need to decide what action to take and consider if you should outsource this crucial element of your practice to a professional billing company instead.

Garry Chapman is managing director at Medical Billing and Collection

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