New Year Resolutions For Better Medical Billing

By Carl Mays II

Most people's New Year resolutions have been abandoned by the end of January. If you find your self in this group then take heart. You can still snatch victory from the jaws of defeat. To do so, you must understand two basic principals of achieving your ambitions:

1. Do not view a minor failure (i.e., you just ate a quart of Ben and Jerry's Ice Cream) as final defeat (i.e., Well I might as well stop trying to give up sweets); and

2. Break your goal down into manageable pieces (i.e., I will lose 2 pounds in January; 2 lbs in February versus I will lose 25 pounds this year).

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:

- You can only achieve it by having a laser focus on the front end elements of medical billing. This is where the medical billing "game" is won or lost;

- 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.

- It lends itself to technology aids. Invest in a scrubber that will help you find coding problems before you submit the claims. Invest in insurance verification tools that will make it easier to have clean demographics. Invest in coding tools that will help improve your data entry performance.

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:

- Measure your current performance level;

- Set your medical billing goals high (96% of all claims will be paid on first submission);

- 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

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