Lost revenue/collection issues

[tmvguy03]

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I am part of a quasi- private practice (under a larger university umbrella) and an transitioning from a salary to revenue-expenses model. Despite being on salary, when revenue didn’t really matter, I’ve been very detailed about keeping track of charges/receipts, and have been continuously frustrated with how disorganized things get once I’ve billed and it goes into a somewhat amorphous system on the university side for processing.
Recently I reviewed a spreadsheet from the last 12 months and identified nearly 70k in lost revenue either from inappropriate write offs, payments below contracted rates, or straight up insurance companies not being billed.

Has anyone dealt with this and what have you done? I spent hours creating my own spreadsheet identifying specific patient encounter/billing issues and sent it to my dept. Any thoughts appreciated, thanks

 

[nvrsumr]

If u don’t do it yourself(I don’t) you will have all the issues mentioned except write offs(until u approve them at least) using any billing company.

70k may not be that bad depending.....

Claims should always go... payment is variable

 

[Cholula]

It is quite possible your university is really good at collecting but not telling you that. I was where you are five years ago when I figured out my employer was fabricating spreadsheets for collections to delay paying me and pay me less. I thought it was odd that they would take the time to make spreadsheets of my collections instead of just print out reports from the practice management software. I audited the collections by calling insurances on random claims and found out if they paid and how much. It was pretty simple doing it myself. I just needed my NPI, the date of service, and patient social security number. Alternatively, you can hire a biller (not affiliated with your employer) to audit some collections for you. They can access the EOB's online. I found out my employer was collecting far sooner and far more than they was letting me know. That's when I left and hired my own biller.

 

[tmvguy03]

It is quite possible your university is really good at collecting but not telling you that. I was where you are five years ago when I figured out my employer was fabricating spreadsheets for collections to delay paying me and pay me less. I thought it was odd that they would take the time to make spreadsheets of my collections instead of just print out reports from the practice management software. I audited the collections by calling insurances on random claims and found out if they paid and how much. It was pretty simple doing it myself. I just needed my NPI, the date of service, and patient social security number. Alternatively, you can hire a biller (not affiliated with your employer) to audit some collections for you. They can access the EOB's online. I found out my employer was collecting far sooner and far more than they was letting me know. That's when I left and hired my own biller.

That’s interesting thx for the advice. I definitely have seen similar issues. The problem that both of us have is simply not having the bandwidth to follow up on every claim, that’s crazy. I have considered going in with some of the neurosurgeons on hiring our own billing person bc several of them have similar issues. It’s a drag to have to do that considering that part of my current and future expenses goes towards paying whoever is supposed to be doing this work in the first place.
It’s like paying $40 for an oil change, then adding a $10 surcharge to have a 3rd party come in and change the oil bc the 1st guy is incompetent...