Massage your wallet

By Chad Fleming, O.D., AOAExcelTM Business & Career Coach

To succeed, it is imperative to have a knowledgeable biller and coder.

Optometrists as a whole tend to be relatively frugal when it comes to managing a practice. Unfortunately, many practices are suffering in today's business environment because the owner-optometrist is unwilling to make appropriate investments in the practice: specifically, in key personnel.

To succeed, it is imperative to have a knowledgeable biller and coder. According to MBA key metrics for 2013, the average hourly salary of an insurance clerk is approximately $16.36. Here are three reasons to "massage your wallet" and compensate your insurance position at a much higher rate than the industry average.

  1. More accurate billing and coding
  2. Electronic health records (EHRs) many times give us the false assumption that if we doctors follow the coding directives of the EHR, we will get reimbursed for our services. A professional experienced in medical billing and coding knows how to look at a record prior to filing to insurance and check for errors and omissions. This is one of the most common reasons that claims are denied, and thus your bottom line (practice net) drops below 30 percent.
  3. Lower insurance accounts receivable
  4. According to the MBA statistics for 2013, having one-third or more of collections greater than 60 days indicates an ineffective collections system. A practice in this situation is losing more money in lost collections than the cost of their insurance staffer. High-performance offices have less than or equal to 10 percent of total accounts receivable in 60 days or more. A professional insurance staff member should also be able to identify, with insurance or private pay, where the problems are should you find your accounts receivable continuing to increase without subsequent production increase.
  5. More paid insurance claims
  6. Not until our most recent hire of an insurance specialist did we see the huge number of mistakes that an average insurance company makes. When an insurance staff member understands how insurance filing, processing and collecting occurs, the boost to the practice bottom line is exponential. One of the best returns on investment is hiring a proficient, efficient and knowledgeable medical insurance biller and coder.

When optometry was glasses and contact lenses only, an insurance clerk could not affect the bottom line of your business as it does today. The majority of successful optometry practices today have made the transition to a more medical model of patient care. Revenues from medical care have increased dramatically over the past 20 years, resulting in a need to bill and code accurately to receive proper reimbursement for your services.

This means that your insurance staff influences the health of the practice significantly. Optometrists can no longer keep up with all the requirements of meaningful use and medical exam documentation without the knowledge and expertise of a professional biller and coder. Speaking from personal experience, we will not think twice in "massaging our wallet" should we ever have to hire again.

May 13, 2014

comments powered by Disqus