Managing Billing Staff Productivity Edie Valencia Billing Director & Corporate Trainer Quick 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 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 3 rd Account Review event  95% of denied trips worked within 5 days of posting  80% call back status compliance for trips in 2 nd Account Review event

3 Account Reviews

Excel Tracking & Score Cards  View our 2012 Productivity Tracking Spreadsheet 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 3 rd 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 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