Children's National Health Network by Richard L. Tamburello, Managing Director, URS Billing Services, LLC

My staff and I recently attended a very enlightening and highly informative seminar presented by the Children’s National Health Network– “Refinancing the Pediatric Medicine Home” – in Bethesda, Maryland.  The seminar attendees consisted of physicians, administrators and support personnel; handouts contained information on the upcoming ICD-10 codes as well as tips on making your practice more profitable.

Congratulations to Dr. Mark Weissman and Dr. Charles Medani for their selection of pertinent and much needed subject matter - `Financing the Medical Home: Moving from Principles to Practice Payment’ and `Coding to Support the Advanced Medical Home’, presented by Dr. Joel Bradley.

Our highlights of the seminar were hearing the questions and answers of the attendees as well as networking with fellow CNHN members.

We at URS take enormous pride in keeping our billing staff updated of recent legislation, coding and technologies and how each can help us better serve our fiduciary responsibilities for medical practice clients. Optimizing revenues, responding timely and accurately to both insurance and patient inquiries are some key factors which help us maintain high revenue levels and fewer accounts written off to bad debt and assigned to collections.

URS will certainly attend the next Children’s National Health Network’s Seminar.  It’s well worth the investment!

Key Tools for Effective Collection Results by Richard Tamburello, Managing Director, URS Billing Services, LLC

All communications with responsible parties owing delinquent balances must be positive.  Never make collection or follow-up telephone calls using abusive or insulting words. The key to improving self-pay collections and maintaining a positive image for the practice or hospital practice, are first explaining to all patients the practice’s payment and collection policies; collection communications should always focus on motivating patients to pay delinquent balances, not antagonize.  Make sure that all policies are acknowledged by both guarantor and the practice.

Responding in spirited and positives tones to patient inquiries is another key element to elevating the prospects of receiving payments from patients.  Staff members need to convey to all patient inquiries the willingness and understanding of circumstances surrounding financial problems some patients might have with paying the balance.  The results can be quite positive.

        

Credentialing – Time Consuming, Detailed and Necessary by Richard Tamburello, Managing Director, URS Billing Services, LLC

URS has been credentialing physicians and practices since 2004.  The staff has developed a comprehensive and effective methodology for ensuring all requested insurance providers are correctly credentialed and contracted.  URS also reviews and completes the CAQH application process. CAQH requires significant amounts of personal and professional data such as the physician’s curricula vitae, medical school diplomas, dates, state and federal licenses and personal references.

Most physicians seeking help completing the credentialing process might have just begun practicing or have transferred to a different practice or might practice medicine under 2 different Federal Tax numbers.  Many practices seek assistance with credentialing because of time and personnel constraints. URS is also capable of assisting physicians and practices with negotiating reimbursement schedules. 

   

Motivated Staff=Accuracy by: Richard Tamburello, Managing Director, URS Billing Services

Motivated staffs are a critical component to achieving accuracy in the overall efficiency of any business. Accuracy in employee production directly impacts the overall profitability of the business. Accuracy improves the bottom line, motivates employees, optimizes cash flow and facilitates a spirited atmosphere of teamwork. I have worked with several senior executives in major corporations who have greatly influenced my philosophy and approach to motivating employees through accuracy.

The first step is establishing standards, goals and objectives, including monetary rewards or other means of appreciation for achievements such as additional paid vacation days. The URS management team has established several key financial accuracy ratios. For example, URS expects 100% of its filed claims to be 100% accurate! Therefore, having established this as the benchmark, billers compete to getting as close as possible to this figure and those who achieve the highest `accuracy ratio' are rewarded. Accuracy ratios not only play a vital role in effectively managing our client’s medical accounts receivables but act as an `invisible manager’ overseeing each medical practice’s production level. That is to say, these analytical measurements dictate to the medical biller  which areas of the billing process are on target and which need undivided attention. Financial rewards have been created for meeting these accuracy measurements and when the medical biller has met all, URS pays an additional bonus. These accuracy measurements have been in place for more than 12 years.


How do you motivate your staff? Any inspiring stories from motivated employees and proud bosses?

Managing Accounts Receivables by Richard Tamburello, Managing Director, URS Billing Services, LLC

Establishing effective A/R management strategies is critical to the overall financial and operational success of today’s medical
practices, especially in a time when most insurance `reimbursement rates’ are trending downward.  Over the next several issues of URS E-Newsletter, I will address several key operational points that will help practices identify financial and practice opportunities along with proven methods for achieving optimal revenues and cash flows. It is unfortunate that many physicians tend to overlook the importance of directly involving themselves in overseeing A/R, primarily because of unfamiliarity and their focus remaining in clinical areas.

In this issue, I present the basic differences between `optimal
revenues’ and `cash flows’.  `Optimal Revenues’ and `Cash Flows’ are terms often tossed around by many trying to sell a variety of products and services. Let’s first address the primary characteristics of `Optimal Revenues’ (OR). OR means that every possible dollar is collected on the date of service. However, as we can all attest, this rarely, if ever, occurs particularly in today’s credit driven economy. Therefore, the challenge is obvious – targeting as close as possible this ideal goal.  The financial concept `Cash Flow’ (CF) refers to the amount of cash which remains available after all required cash outlays are paid in a 30 day period.

These two critical aspects of managing A/R are challenges that today’s medical practices must vigorously pursue. Keep in mind, though, they are becoming increasingly complex, time consuming and require an astute, dedicated management team and motivated staffs. In the next issue, the focus will be on the importance of establishing `tolerance ratios’ for key designated success factors and why working together as a team delivers positive results.

Other than the financial aspect, what do you find most contributes to your success?

The Importance of DTRs by Richard Tamburello, Managing Director, URS Billing Services, LLC

Establishing `Delinquency Tolerance Ratio’s’ (DTR’s) is one key success factor by which to minimize the practice’s investment in A/R.  DTR’s should be set-up for all major insurance providers, including self-pay accounts. Implementing strict guidelines help to ensure that your practice not only minimizes its investment in A/R but produces optimal cash revenues on a consistent basis.

As a general rule, we use the following DTR ratio targets for managing our clients A/R. These ratios are to be used as target guidelines for insurance and self-pay balances: < 30 days = 75% - 80%, < 60 = 10%, < 91 = 5%, < 121= 5%, > 120 = 5%.
  
For example, the first and most important part of effectively managing and receiving payment is making sure ALL patient demographics, including insurance data, are correctly entered and verified prior to submitting claims. At URS, the staff is trained and tested, trained and tested when it comes to this essential `key’ phase of medical billing. Consider the negative financial consequences when carelessness replaces accuracy.

What financial ratios do you most often use in your day to day work life?