Anyone else experiencing decreased collection rates? Increased AR?

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It started about mid-2014, after our billing company got bought out. We immediately saw our collection rates creeping down. AR held for a little while, and then went through the roof in 2015.

Our billing company tells us that the decreased collections are due to Obamacare's high premium/high deductible plans. The AR is due to not having enough staffing to work the accounts in a timely fashion; some of the accounts are a year old!

I am at a loss as to how to deal with this. We've yelled and screamed at the company for years to get its act together, and while they express a desire to do better, I can't see what they've done to substantively improve things.

Advice? It kills me that perhaps the main reason why we're not doing as well as we have in the past might be because of our billing company!

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[LADoc00]

Tell me you arent using GGB now ORS....

 

[coroner]

Same story different reasons. Met with our billing manager last week about to discuss such issues and we were wondering what was going on as far as the decline in revenue when our volume and most recent reimbursement rates have been stable.

In our case it’s primarily attributable to transition to ICD-10. Although CPT hasn’t changed, we are seeing delays because the coders need to look up previously memorized codes and if they’re done incorrectly that adds even further to the delay. We are also seeing carriers paying slower as we have still have lingering AR which is slightly higher. There was no significant mention about Obamacare premiums/deductibles.

There are some other reasons which are specific to us and our billing company e.g. billing company’s Pathology dept. is now being handled by a different branch in a different state, electronic tracking of patients reports rather than mailed/faxed, etc. This inadvertently affected daily balancing reports and accession tracking, so you may want to make sure your office manager/path office & billing company is staying on top of that.

Another small component too is PQRS which could cost some practices as little as couple of hundred bucks a year to the low thousands depending on their volume if they’re not doing it. Also, there’s no reason you can’t re-assess your fee schedule for private carriers and propose a slight increase and see if that yields any dividends.

As far as your billing company, I don’t know who you use, but we use McKesson and they have a pretty good rep and are one of the nation’s biggest. Athough quality of service can also be affected by one’s waitress as well as than the franchise they’re dining at. In other words, it may be time to start going to Maggiano's instead of the Olive Garden. Another thing your practice may consider is hiring a billing auditing company e.g. Vachette as a consulting service. But, they have a pretty hefty fee you pay upfront. And, if they don’t find any significant deficiencies in your group’s billing practices, you ain’t gettin’ a refund. Finally, our billing manager mentioned that we should catch up as the year progresses, so there does seem to be hope…

 

[AZpath]

Corner,
I know several groups including mine who dumped McKesson. My change is recent so don't have the loss comparison yet.
My pal at another practice is telling me they are now collecting 25-30% more with their new biller verses McKesson.

However, I know big lab group that also claims they do a great job. So your mileage my indeed vary.

I highly recommend audit by Vachette to anyone concerned about billing. They saved me from going out of business.

I have known the owner Mick Raich for a number of years. He told me billers have a life cycle. Young-inexperienced, experienced-hungry, fat-lazy. The good mid life cycle biller is the one that usually give the client the best service.
Once they get bought out by a much larger biller then often convert to late life cycle.

The big billers would rather leave money on the table rather fix problem claims. It cost more to fix problems. They would rather pick the low hanging fruit and keep their labor costs down.

 

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It's infuriating, knowing that a certain percentage of my efforts is wasted just because my billing company doesn't think it's worth their time to go after everything I'm owed.

 

[MOHS_01]

Same here, fellas. Worse still, the payer mix is degrading and bad debt has exploded. Thank you, congress - at least before the ACA I knew beforehand who wouldn't pay and I could space them out accordingly. No longer.