Topics

1. Managing Billing Staff ProductivityEdie ValenciaBilling Director & Corporate TrainerQuick Med Claims

2. Topics • Staffing Model Overview • Setting Productivity Goals • Excel Tracking Spreadsheet and Score Cards • RescueNet Reports Used • Payment Posting Tracking

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. Minimum Standards • Pre Billers • 50-60 trips per day • Billers • 50 trips per day • Pre Bill Assistant • 30 trips per day (pre bill)

10. Minimum Standards: Follow-up • 95% call back status compliance for trips in 3rd Account Review event • 95% of denied trips worked within 5 days of posting • 80% call back status compliance for trips in 2nd Account Review event

11. 3 Account Reviews

12. Excel Tracking & Score Cards • View our 2012 Productivity Tracking Spreadsheet • A blank tracking spreadsheet will be available in your Summit materials package

13. 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 3rd Account Review • Click here for example

14. 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

15. RescueNet Reports Used • Trips Verified by Biller • Biller productivity • Includes drill-down to view run number, call type and payor • Click here for example

16. 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

17. 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

18. 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

19. 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?

20. In Summary • Develop productivity goals and share with your staff • Hold staff accountable • Celebrate victories