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Hire Compentent Billers

Hiring the right biller can be a challenge. They interview well, but how do you know they are competent? Give them a test. Nothing complicated, just give them an EOB with some basic questions. If they don’t understand the difference between what a payer allows vs. a contractual write-off or they can’t calculate the patient’s responsibility or they can’t tell you what network is being accessed, then you need to continue looking.

Once you hire competent staff, here are some suggestions to support them:

1. Make sure your staff know who the provider is contracted with including payers, leased networks, insurers, etc.
2. Ensure your fee schedules are properly loaded in your software. Make sure to update them for any cost of living adjustments or annual changes such as Medicare.
3. Ensure the staff know the timely filing requirements of the different payers, including for appeals.
4. Get your patient statements out promptly.
5. Do audits to ensure your staff is performing well. More training may be needed at all levels. Don’t assume because their title is Supervisor that they don’t want training. There is always something new to learn.
6. Last, but not least, send in your appeals! Too much money is left on the table because appeals are not sent in. If you provided the service in accordance with your contract then fight for your money. Don’t be afraid to send in second level appeals or get your provider representative involved.

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