[Insights] Navigating the Complexities of Billing in a Multi-Location Practice

Five reasons your billers struggle with efficiency and how to help.

By Melissa Jacobson, OneSpot Manager of Operations

Billers of multi-location practices often go to extremes to manage their accounts receivable (AR).

One biller confessed that she once transported stacks of Explanation of Benefits (EOBs) in her car because she was regularly forced to pick up files and manage them at different locations. The stacks of files had Post-it notes with reminders, necessary for completing filing and follow-up. Looking back, she now realizes how dangerous this practice was in terms of patient health information (PHI) security.

But what were her options?

This is just one of the many complexities of insurance billing in multi-location practices. Many practice owners aren’t aware of the struggles billers face. Most billers and practice managers don’t complain; they just get it done, even if the process is manual and inefficient. Yet, billers wish there was an alternative to streamline their billing while remaining HIPAA compliant.

There are several critical billing issues that elude multi-location practices that need to be addressed to streamline processes, keep on top of AR, and comply with HIPAA.

Password Management

Password management is a pain for all of us, especially when you share accounts (think of the last time your significant other changed the Netflix password and didn’t let you know. What a pain!). It’s similar for billers at multi-location practices. Although there is a trend towards providing each employee with individual logins to minimize issues, shared passwords still cause confusion and inefficiencies.

It's not uncommon for billers to jot down passwords on Post-it notes or file them in a binder with other documents where they easily get lost. There are times when they can’t find their password, so they reset it.

A notification is sent to the user who changed the password, but not everyone. In a hurry, the biller doesn’t think to document the new password and share it with colleagues. Unable to log in, the next user changes the password, creating a never-ending ripple effect.

A simple solution is to take the passwords out of dispersed binders and spreadsheets and share them in a secure, cloud-based location.

Staff Turnover and Training

With more locations comes more employees. And with more employees comes the potential for a higher turnover rate. Each new hire introduces a steep learning curve. Often, billers are left to fend for themselves, learning the intricacies of billing as they go. This “learn-on-the-fly” approach can lead to errors and inefficiencies, such as data entry mistakes, coding errors, duplicate billing, missed deadlines, and incorrect modifiers. Through no fault of their own their billing knowledge is fragmented, incomplete.

These issues can significantly impact the overall efficiency and accuracy of billing operations, leading to delays and financial losses. That’s why it’s crucial to have robust communication tools and a centralized repository of practice policies and procedures. Having a centralized spot for training material and logins aids new staff in their training while also ensuring that everyone, including long-term employees, has access to the most current information.

Shared drives, while useful, often fail to meet HIPAA compliance standards. A centralized and secure system ensures that all staff members have access to up-to-date information, reducing the risk of errors and enhancing transparency. This becomes even more crucial as the number of practice locations increases. This can be the most useful tool in providing training and support to new staff while getting them up to speed.

Remote Billing and Document Security

In multi-location settings, one biller often handles tasks for multiple locations. This can lead to logistical challenges, such as the physical transfer of documents, which is highly risky in terms of PHI security. Not only does this pose a significant risk of data breaches, but it also increases the chances of documents being lost or damaged.

The inefficiencies of manual document handling extend beyond security risks. Billers may spend excessive time organizing, tracking, and retrieving physical documents, which could be better spent on more critical billing tasks. This manual process can also lead to errors in filing and delays in processing claims, which further complicate the billing workflow.

Implementing a secure system for managing and accessing billing documents remotely can prevent such risks and ensure compliance with privacy regulations. A centralized, cloud-based document management system allows billers to access necessary documents from any location securely. This not only enhances data security but also improves efficiency by reducing the time spent on document-related tasks.

Moreover, a secure electronic system can include automated tracking and reminders for document handling, ensuring that billers follow up on claims promptly and accurately. By eliminating the need for physical document transfers, practices can streamline their billing processes, reduce the risk of errors, and ensure better overall management of patient information.

Aging Reports and Payment Tracking

Effective management of aging reports and payments is another critical issue. In multi-location environments, payments are often centralized, leading to delays in communicating payment statuses to individual locations. This miscommunication can result in unnecessary work, such as reworking claims that have already been paid, and missed deadlines for follow-up actions, which can lead to revenue loss.

Without a transparent and efficient system, billers, whose time is valuable, may spend excessive time tracking down payment information and manually updating aging reports. This manual process is prone to errors, complicates the billing cycle, and can lead to discrepancies in financial reporting.

Implementing a robust, real-time system for tracking payments and aging reports can streamline these processes. It allows all relevant staff members to access up-to-date payment information, reducing the risk of miscommunication and errors. Automated reminders and alerts ensure that follow-up actions are taken promptly, preventing missed deadlines and enhancing overall efficiency.

A transparent system improves accountability by enabling staff to see who is responsible for specific tasks and follow-ups. By providing clear visibility into the status of payments and aging reports, practices can reduce unnecessary work, improve accuracy, and ensure a more efficient billing process, leading to better financial management and optimized revenue cycles.

Multi-State Operations

As practices expand across state lines, the complexity of managing billing operations increases significantly. Each state may have its own Medicare contractors, specific regulations, and unique payer requirements. This variability can lead to confusion and errors if staff members are not well-versed in the state-specific rules and procedures.

What is acceptable in one state might be entirely different in another, leading to potential compliance issues and claim denials. Ensuring that staff members are trained and knowledgeable about these differences is crucial. A centralized knowledge repository becomes vital in such scenarios, serving as a single source of truth for all regulatory and procedural information.

This repository can include detailed guidelines, training materials, and updates on state-specific regulations, ensuring that all staff members have access to the most current and accurate information. Furthermore, having a centralized system helps standardize training across locations, ensuring consistency and reducing the learning curve for new hires.

It also facilitates quick updates and dissemination of information when regulations change, preventing delays and errors in billing practices. By maintaining a robust and accessible knowledge repository, practices can better navigate the complexities of multi-state operations, ensuring compliance, reducing errors, and improving overall efficiency in their billing processes

As a multi-location practice, you enjoy the upsides of serving more patients. However, this expansion brings complexities that your billers must navigate daily. By implementing a robust billing software solution, you can help your billers do their job more effectively, easing their pain and streamlining their tasks. This doesn’t just reduce errors and enhance data security. It also supports the overall efficiency and productivity of your practice.