Medical Coding Certification — Going Green

Let’s stop and think about the concept of “going green”. It sounds like a grand idea, and admittedly, in some cases going green really works. Let’s begin by studying the impact “going green” has in the medical practice or medical billing service. This is a health care industry concern that is not taught when studying to be a physician practice manager (PPM) or even a medical biller.

In this age of technology, we are finding that we must transfer patient information electronically, and transmit self-pay invoices and claims electronically. We also receive payer remittances electronically which post to the patient’s accounts electronically. In addition to the electronic remittance, physicians are now receiving their payments through electronic fund transfers into designated checking or savings accounts.

This brings managing a medical practice or working in a billing office to an entirely different level.

First, let’s talk about the expense. Insurance companies may be saving money because they are downloading all their information into a database for the medical practice or billing office to download and printout. Ask yourself this: How much money are you spending purchasing cases of paper to accommodate the “going green” concept imposed upon us by the insurance companies? In the past few months, how many more payers are mandating that you go electronic? How much time does it take to print out every single remittance advice from the numerous carriers that mandate you print your EOBs now? Who reconciles your deposit account? The billing department receives the electronic remittances and posts them as paid. The doctor’s office and the PPM receive the checking account statements. These two departments must somehow develop a means to communicate the dollar amounts that are being posted against the dollar amounts that are being deposited.

Medical Coding Certification – Going Green

There was a time when the dollars posted would balance to the check that was attached to the EOB. The billing department then deposited the check in good conscience, knowing everything was reconciled. That is not the case now.

I just had an experience where one of our major carriers posted two large surgical payments to a hospital account instead of to our physician’s. Fortunately, my employee made her follow-up calls at the end of the month and discovered the problem.

Our office provides a log of downloaded eobs indicating the deposited amounts and presents this information to the PPM. However, the PPM is not going to know if the claim was paid or if the claim was paid to someone else unless we provide that information. The point is, some practice managers are so overwhelmed with all the other responsibilities of managing a practice, particularly with PQRS and meaningful use being enforced, that reconciling the checking account deposits to the billing office deposits is not often something they prioritize.

Besides, wasn’t it easier to reconcile one large deposit for $10,000 opposed to 10 individual deposits of $1000?

Depending on the size of the office, PPMs and medical billing managers must stop and think of how this electronic communication can be reconciled in a simple, clear cut way.
Ask yourselves this- how much time is it taking to download all the payers’ explanation of benefits? How often does it have to be done per week? How many medical billing departments have to download and print billing summaries of the day or week’s patient encounters? How long does it take to record all these deposits for the practice? Who is in charge of reconciling the numbers?

At this time, I am seriously considering hiring a clerk to simply download all the paperwork that needs to be downloaded on a daily basis. I am also planning on charging a fee for the amount of time spent, as well as the additional money spent, on the reams of paper that I am going through to print out this information that allows the insurance companies to “go green”.

I am all for technology. However, being in this industry for as long as I have, I cannot rely solely on saving things with a backup system. The liability is too great. Too often equipment fails and items get lost in cyber space. There is just something comforting in knowing you hold in your hand a hard copy of anything that comes through to our office electronically. Call me old-fashion!

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