200 likes | 336 Views
Discover key strategies for improving billing productivity through effective staffing models and clear productivity goals. This guide covers essential topics, including staffing ratios, productivity tracking using Excel spreadsheets and RescueNet reports, and methods for setting daily trip processing goals. Learn how to monitor staff performance across different roles, promote accountability, and celebrate victories. Implement best practices for managing pre-bills, follow-ups, and payment posting to optimize your billing operations. Perfect for billing managers and corporate trainers aiming to improve team efficiency.
E N D
Managing Billing Staff ProductivityEdie ValenciaBilling Director & Corporate TrainerQuick Med Claims
Topics • Staffing Model Overview • Setting Productivity Goals • Excel Tracking Spreadsheet and Score Cards • RescueNet Reports Used • Payment Posting Tracking
Staffing Model Overview • Our Staffing Model • 1 Biller for every 5,500 transports • 1 Poster for every 40,000 transports • Billing Manager counts as .5 FTE • Half of their time should be spent on activities directly related to claims submission or follow-up
My Billing Team • 10 Staff Members • 3.25 Billers/Coders (F10) • 2.5 Pre Billers • 2.25 Follow-up Specialists • 1 Pre Bill Assistant (pre billing and clerical tasks) • 1 Account Manager (supervisor) • 1 Payment Poster
Pre Billers • Primary Task • Patient demographics and insurance verification • Productivity monitored by counting the number of trips with a Pre Bill note type • Secondary Tasks • Returned Mail • Collections Review
Billers • Primary Task • Follow all pertinent rules and regulations to move the trip into a verified status (F10) • Productivity monitored by counting number of trips verified each day
Follow-up Specialists • Follow-up Specialist • Separated by payor type (Care, Caid, Commercial) • Work denials and misc correspondence received from payors • Follow-up on past due claims (Account Reviews) • Productivity monitored by tracking number of trips in various follow-up related events and call back status
Setting Productivity Goals • Number of trips to be processed each day is calculated • Average Weekly Trip Volume / 5 business days • 850 / 5 = 170 Trips per Day • Average weekly trip volume is analyzed at least twice per year
Minimum Standards • Pre Billers • 50-60 trips per day • Billers • 50 trips per day • Pre Bill Assistant • 30 trips per day (pre bill)
Minimum Standards: Follow-up • 95% call back status compliance for trips in 3rd Account Review event • 95% of denied trips worked within 5 days of posting • 80% call back status compliance for trips in 2nd Account Review event
Excel Tracking & Score Cards • View our 2012 Productivity Tracking Spreadsheet • A blank tracking spreadsheet will be available in your Summit materials package
RescueNet Reports Used • Call Back Status by Event • Gives high level overview of follow-up status. Not part of individual employee performance monitoring • Account Manager and Billing Director receive bonus when quarterly average exceeds 95% call back compliance for trips in 3rd Account Review • Click here for example
RescueNet Reports Used • Call Back Status by Payor Category • Follow-up staff productivity monitoring • Report is run at the close of business on Friday • The value for Current Call Backs is entered • Click here for example
RescueNet Reports Used • Trips Verified by Biller • Biller productivity • Includes drill-down to view run number, call type and payor • Click here for example
RescueNet Reports Used • # of Trips Pre Billed • Use the report: Trip Count by Note Type • Restrict for just the Pre Bill note type • Includes drill-down to view the run number, time of note and actual note • Click here for example
RescueNet Reports Used • # of Follow-up Notes • Same report as above but restrict for the Follow-up note type • All custom reports and will be included in your Summit materials package
Payment Posting Tracking • Unable to determine a way to monitor productivity through RescueNet • Primary tracking is based on how many days out we are • What day are we posted through? • Daily Log
Future Goals • Consolidate employee productivity numbers quarterly/annually and include as part of the employee’s annual review • Develop an incentive program based on quantity and quality • Compliance audit results will be incorporated • Does anyone have an incentive program you would be willing to share with me?
In Summary • Develop productivity goals and share with your staff • Hold staff accountable • Celebrate victories