Common Misconceptions: Loss of Control

Many of us are in need of control, in some cases desperate. There is a common misconception with using a medical billing service that you need to give up control. Not only is this not the case, but you are actually in more control.

First off, URS Billing Services doesn’t touch any money. This can be your first order of business to cross off your check list. 

Second, because we are professionals in the medical billing field (just like you are professionals in the healthcare field) we are aware of every modifier, diagnosis, chief complaint needed in order to get your claims not only paid but paid at their maximum allowable. 

Last but not least, you are in even more control by using URS Billing Services. How? 

1. You’re paying for what you get. Let’s look at this from an employee of your office: They are going to get their paycheck regardless if they get a claim paid or not. Sure, they may get a bonus if they get it paid but they can still rely on that weekly paycheck. 
1. You are not only paying their salary but you’re also paying for their computer, their software, their software updates, their training, their time off, their sick days, their maternity leave...
2. By using our service you are getting more bang for your buck. By increasing your monthly revenues you have the option to take off time with your family, or maybe use that extra money to open an extra office, what will it be? 
3. You have full access to your billing representative, no automation system to dial in to, you pick up the phone and ask your representative any question you have about your account. How often do you go to your employee’s desk to ask a question and you find out they’ve called in sick? 

Go ahead and give our office a call today, receive a free A/R Analysis to see how we can help you.

www.e-urs.com

1-800-229-3994

5 Way to Improve Profitability

1. Increase patient volume - The first step to improving profitability, in most practices, is attracting more patients. Many patients select or are referred either from referrals, by specialty, relatives, word of mouth or friends. There are many ways of attracting new patients to medical practices. First – asking current patients to refer friends, relatives and establishing an effective referral system or using a marketing service.

2. Contract a physician liaison - Once a practice has established its operating philosophy, communicate with other geographically located physicians, regardless of specialty, which services are available. This process can be effectively conducted by contracting with a marketing service of hiring a physician liaison or sales/marketing manager.


3. Communicate with both primary care and specialists - Communicating and establishing relationships with physicians in your practice’s geographical area, including those who currently refer patients, is an important key and ensures many physicians will likely refer to your facility, says Richard Tamburello, Managing Director of URS Billing Services, L.LC. "Maintaining open communications and providing follow-up reports and updates to the referring practice is important and should not be overlooked. Open communications with all physicians is important, especially to referring physicians and primary caregivers. There will be at some point in time in the patient’s history that insight, support and treatment might require exchange of thoughts and possible treatment", says Richard Tamburello, Managing Director of URS Billing Services, LLC

4. Provide referring physicians with the clinical results and services they expect - This is where many practices have fallen short because of time, shortage of personnel or neglect. The number one key information piece some treating physicians fail to disclose to referring physicians is the open line of communications. It is not only a professional courtesy, but providing results of the treatment to the referring practice helps the practice by receiving insight of the results. Plus, instituting open lines of increases the prospects of receiving more patient referrals.

5. Maximize each physician’s case load - Once the practice establishes a comfortable patient load level, including referrals, physicians should at levels that sustain quality level of care and maintaining good bedside manner. One method is offering bonuses or other incentives based upon meeting and exceeding established patient treatment goals. For example, front desk personnel should take patients from the waiting room to the procedure room. Once the patient is settled, set a time frame in which the patient is seen by the doctor (5 minutes, 7 minutes or maximum of 10 minutes), then track the time and possibly incorporate a `special recognition’ award to the physician and front desk personnel. Although there is some resistance to this procedure, increasing case load is not about rushing procedures but accelerating other aspects of the visit - registration, insurance verification, setting a patient up in a room and discharge.

In conclusion, these are just a few ways to improving efficiencies and the profitability of the medical practice. Today’s medical practices need to `re-exam’ and re-evaluate ALL internal operations and fine ways to optimize revenues and better manage production, labour and benefit costs. If current operations are not changed or effective innovative marketing concepts not implemented, there will be fewer dollars left at the bottom-line the end of each month and at the end of the year.

5 Tips for Successful Debt Collection

Here are some tips to implementing a successful collection of delinquent accounts. As part of our ongoing and presence in collections, we ask for your input. Please respond to the article if you have other tips and suggestions from your successes or if you questions. Please click on the below link.

1. Correct/Updated Demographics—It is veryimportant to ensure that ALL debtor(s)demographics are correct and current –complete full name, telephone number(s), home address(s), amount(s) owed, balance,age of account(s) and type of account(s). These data can be verified from theinstitution’s database, financial transactions, credit bureaus and various skip tracing websites. It is key to make sure debtor addresses are correct to ensure debtor is receiving all appropriate delinquent notices and information about the debt.

2. Sending Notice(s)—Notices should contain all pertinent information regarding the debt including balance due, amount past due, date and amount of last payment and importance of the debtor(s) contacting the banking institution. Notices should be mailed at specific intervals for maximum effect. For example, the firstnotice of delinquency is mailed 14 days past the contracted due date. Thesecond notice is mailed 21 days of due date and if no contact by the debtor hasbeen received explaining why payment is late or agreeing to payment arrangements, the account should be assigned to the collection for the `pre-30’collection approach.

3. Professionalism— one important key to achieving effective collection rates is maintaining professionalism. Professionalism, in concert with firmness and understanding, is absolutely necessary to achieving maximum results. Collectors should offer various payment options and taking into consideration debtor’s current financial situation and within the bank’s collection policy guidelines. Collections is an art and learning and understanding its purpose will add positive tones and results. Debtors will give many reasons for not making payments, but collectors must be patient and carefully listen to what is being said by the debtor. If debtors are expressing severe medical issues, a death in the family or other viable financial problems, collectors need to understand these dilemmas and offer other options in concert with the bank’s collection policies.

4. Working with Debtors—Debtors might not have the money to make a full payment, therefore it is important to work with the debtor(s) and offer alternative payment options which, of course, follow corporate collection policies. Some banking institutions have within its policies the option to settle accounts up to 15% of the total balance if paid within specific time periods. However, the ideal solution is working with delinquent customers and having them return to a satisfactory standing within the bank.

5. Accessibility to the Bank—Delinquent customers should be given several options for making payments or having accessibility to certain branches for making payments. When collectors send out notices or make follow up phone calls, collectors have to make it clear where or how debtors can make payments.

Motivating Debtors to Pay - The Effective Collection Tools

The overall goal or game plan for all commercial institutions is maximizing revenues with the fewest telephone calls and collection letters. Developing and implementing effective collection techniques requires skillful communications skills.

Collecting delinquent accounts is an art but, in many cases, a necessary evil for achieving revenue goals. In my 35 plus years of collecting and managing large collection staffs, I have found greater successes result from techniques which emphasize positive attitudes and motivational approaches with debtors. Contact with debtors should include phrases such as, “Mr. Debtor,my name is John Doe, I ‘m with the 3rd National Bank and calling because your account is past due and the bank wants to know you are able to make it current”? Typically responses fall into one or more of the following categories: “I’m currently unemployed and looking for work”, “my hours have been reduced”, “my husband is temporarily laid off or “my wife is unable to work for the next several months”. The positive approach is showing concern for the debtor’s unfortunate circumstances and responding by saying, “Mr. Smith, you’ve had a very good record with the 3rd National Bank over the past several years and would certainly want to help you return to that status. So let’s work on a plan that is acceptable to the bank and you”.

Greater successes have resulted with this or similar approaches than with more aggressive and unsympathetic tones. Of course, there are going to be many situations under which this approach might not be feasible with the bank’s operational policies, specifically when it involves secured loans. For example, in the case of automobile loans, the bank’s policy might state that secured auto loans cannot be more than 2 contractual payments past and must be brought current within 2 weeks or repossession shall be considered. Always keep in mind communications with debtors should be positive and carry motivational tones, regardless of whether collecting secured or unsecured loans. This approach has always achieved much success for many, many years and, more importantly, banks do not want to repossess any type of vehicles or litigate for deficiency balances.

May the Banking Industry See Greater Prosperity in 2012

Banks are hoping for much greater economic activity and growth in 2012. But, based upon the latest economic statistics, we are looking at a sluggish 2.0%. Many economists are speculating that a slow movingeconomy will be attributed to new and lingering banking regulations. For example, larger banks will be required to limit their financial ties to one another under new proposed rules aimed at preventing the collapse of one big institution from triggering a larger, cascading crisis.

The net credit exposures between any two of the nation's six largest financial firms, including J.P. Morgan Chase & Co. and Goldman Sachs Group Inc., would be limited to 10% of a company's regulatory capital, under a proposed package of regulations released by the Federal Reserve on Tuesday. Most other firms covered by the rule would be subject to a 25% limit, as required by the Dodd-Frank financial-overhaul law.

The new 10% limit for the biggest firms was unanticipated by the banking industry and has the potential to scale back the capital-markets businesses of large institutions, analysts have said.

Credit restrictions are just one piece of a tougher set of regulations the Fed has drafted which apply to the nation's largest, most complex financial firms. These stricter rules are aimed to reduce the ability of any single financial giant to damage the financial system and the broader economy, and is one of several ways Dodd-Frank attempts to end the "too big to fail" phenomenon that led to huge taxpayer-funded bailouts.

It is quite apparent that the more the federal government imposes its iron hand of federal regulations upon banks and related credit companies, increased inefficiencies will negatively impact bottom-lines. This result ultimately decreases investor incentives and could also negatively impact respective stock values; hence 401k and other retirement financial vehicles.

Well, folks these trying times have resulted from a class of economic illiterates who not occupy most government agencies but elected officials who are primarily concerned about their own well-being and re-elections.

Good Luck and call us to help your financial institution see more black than red!

Merry Christmas and Happy Chanukah?

We at URS are wishing everyone the best over this fun filled holiday season of joy and happiness. Well, at least to all those financial institutions which are under the pressing thumb of the `Powers That Be’. The banking industry is becoming increasingly difficult to expand its customer base and grow bottom lines.
Consider the following recent and pending stranglehold tactics:
- Disclosures, notices, statements, forms and tax documents — about 300 pages and just for home loans. Bank processed 455 home loan applications and they created more than two months of `make work’ and the estimated labor costs reached $12,000.
- One bank vice president says the Dodd-Frank Wall Street Reform and Consumer Protection Act, which became law in July 2010, nearly doubled the review and reporting process to regulators, with little margin for error. And that is only a portion of the avalanche of new regulation that has executives at smaller banks concerned.
- The bill is massive — 2,300 pages — and bankers expect it to result in 5,000 pages of new rules as regulators turn its mandates into specific instructions for financial institutions in coming years.

Bankers are very concerned about the abundance of new legislation because it will choke neighborhood banks’ bottom line and virtually place them as prime targets for takeovers by larger, national banks. This legislation appears to have been cultivated by some devious and purposeful late night `strategy meetings’ by certain Congress people and bankers. But then again, this is purely speculation.

Small banks in America have been disappearing for decades. For example, in 1984, the largest banks in America — those with more than $10 billion in assets — controlled 28% of the industry, according to FDIC data. Now, these larger banks control 79% of the market. Banks with less than a billion in assets are holding 11% of the market, compared with 40% in 1984. Bankers believe Dodd-Frank will hasten the consolidation.

Bankers are very concerned about the abundance of new legislation because it will choke neighborhood banks’ bottom line and virtually place them as prime targets for takeovers by larger, national banks. This legislation appears to have been cultivated by some devious and purposeful late night `strategy meetings’ over the past decades by certain Congress people and bankers. But then again, this is purely speculation. Since the 1800’s, neighborhood banks have been instrumental in cultivating small geographical population areas and today this wholesome and warm relationship is slowly disappearing.

More Government Intrusion...Why?

Illinois Democrat, Dick Durbin, has pushed legislation which went into effect a week ago. This legislation limits the fees big banks collect from merchants and he now finds himself the fall guy for Bank of America’s new $5 monthly debit care fee. His response was a ranting and raving and even suggested that consumers “get the heck out of that bank”. Holy cow, you’ve got to be kidding me! Since when does a politician publicly denounce a specific business entity then recommends do not buy or use its services?

Many Americans have always been under the impression that they have the capabilities of deciding which goods and services better suit them, including prices. Over the past several years I have noticed that the intelligence level of Americans has precipitously declined and, fortunately, some Senators and House members are there to rescue us from any and all financial disasters.

I firmly believe that when unfettered competition is allowed to determine the value of products and services offered, businesses and individuals are fully capable of taking decisions as to which products or services serve them best based upon specific cost-benefit evaluations. However, over the past several decades, politicians have been forcing their influence into both consumer and business buying habits of certain products and services. It appears this trend has taken effect because many politicians are easily convinced through glib lobbying persuasion tactics. For example, company A has been investing millions into its new business service software products and, unfortunately, several competitors have quickly developed products which have cut into company A market and, in some cases, have received positive news. In order for company A to regain its market share dominance, it solicits the services of a renowned lobbyist who successfully influences politicians to place expensive legal restrictions, special software licenses and federal and state licensing restrictions to legally market similar services. Smaller and new entrants might find these new restrictions to be cost prohibitive and leave the competition thus freeing up company A to greater success.

Similar tactics have proven successful in the banking industry when large national and regional banks place additional financial burdens on local and smaller successful banks. This would include enforcing greater scrutiny on mortgage loans, including larger down payments and imposing larger reserve funds. The latter reduces available funds loans and constrains cash flow. So sooner or later these smaller banks become increasingly frustrated and sell to a larger financial institution. One way smaller banks can extend life is to evaluate and utilize the talent of outside sources. This serves several critical financial benefits such as savings on hiring and training personnel in the collection or credit granting departments. Banks can observe, manage, evaluate, change, observe and manage operations at the drop of a pen.

Outsourcing: Should We?

Credit decisions greatly impact and influence revenues, bad debts and bottom lines. In today’s weak economy many or should I say most bank credit departments have tightened the rains on extending credit. Today, this practice is evidenced in fewer mortgages, personal and business loans applications and approvals.

As a result, many banks and related financial institutions are reducing employee levels by offering early retirements and imposing terminations. It is likely that the current economic conditions will continue for several more years. The housing market is still sluggish and it is having a domino effect on all those businesses which comprise the housing industry: masons, carpenters, roofers, window manufacturers, landscapers and many other related small businesses.

These unfortunate, poor economic times are causing many businesses to rethink how better to control and manage billing and collecting departments. Although there are `ebbs and tides’ in our economy, businesses are re-thinking and re-evaluating the cost-effective attraction of outsourcing some and all these related departments to professionals. There are several clear advantages outsourcing offers; one of which is that the client only pays for results. For example, ABC Bank employs a staff of 20 in the collections department and it costs about $500,000 – $600,000 in salaries and benefits. These fixed expenses remain constant regardless of the level of generated collection revenues.

The company which outsources its collections department only pays for results. That is to say, using the same example, ABC Bank contracts a professional outsource company to conduct the same responsibilities produces about the same level of revenues, yet it would cost the bank about half the amount, but all of the headaches.

There are additional benefits that can result from outsourcing: fewer personnel to supervise, better manage reduce payroll and related expenses, develop new products and services, promotion of personnel to more challenging positions and, more importantly, grow the business.

Finally, businesses and banks are and will be accumulating data and taking decisions on the financial benefits of outsourcing certain or all aspects of collections and credit granting processes. The ideal outsource candidate has in-depth personal and business loan credit and collection experience, performs credit approvals utilizing secure web-based credit bureaus and criminal background checks resources. It’s becoming quite clear that businesses which are on the cutting edge of growth and market penetration will dominate tomorrow’s businesses.

Bad Debt Syndrome by Richard L. Tamburello, Managing Director

Given the unfortunate economic circumstances for millions of Americans, more and more medical practices are finding it increasingly difficult collecting deductibles and self-pay balances.  This situation is not only impacting cash flow for practices, but negatively affecting bottom lines.  According to a recent study published in the American Journal of Medicine, 2007, “Medical bills are the cause of more than 60% of all bankruptcy filings in the United States…” Many patients ask, “Why aren’t insurance plans covering more of the medical expenses”? As a result, medical practices are now dealing with the uncomfortable task of asking patients for payments after treatments and before they can be seen on the following appointments.

URS recommends the following to minimizing bad debt losses and maximizing cash flow:

1. Inform patients of payment policies prior to being treated. Office policies should include a list of accepted credit cards and a credit agreement which is to be signed by patients/guarantors who do not have insurance or high deductibles (HSA).
2. Select patients for collections using these criteria: Minimum of 3 statements and no contact from patients indicating willingness to arrange payment plans; balances > $49.99; mail is returned.
3. Contact with patients should be geared to `motivating’ patients to pay, not via intimidation tactics.
4. Patients with insurances should have their policies (including secondary insurance) validated prior to the office visit date.
5. Surgical practices need to call insurances for eligibility, authorizations based upon Diagnosis codes presented in ascending order.  This should be completed a minimum of 48 hours prior to the scheduled surgery date.

Keep in mind these are some basic procedures by which medical practices can minimize the Bad Debt Syndrome in today’s economy and in the future.

The Importance of Conducting Insurance Follow-Up by Richard L. Tamburello

Insurance follow-up is a billing function for ensuring optimal revenues, minimizing bad debts, reducing patient complaints and accelerating revenue cycles. Over the past 15 years, I have conducted numerous A/R analyses for various-sized medical practices and have found this key aspect is often overlooked. In some cases unpaid claims are re-filed without determining and correcting the cause of denial resulting in an endless cycle of rejections. When the watchful eye of the doctor or administrator is omitted from this vital task, valid charges are written off.    

How does a physician or practice manager know when denied claims are promptly addressed, corrected and re-filed?

I recommend the following method: 

•    Run a 'Total A/R Aging Report' using the parameter 'Date of Service'
•    Do not run reports showing 'Insurance Re-billing or Billing Dates'
•    Generate a 'Patient Balances A/R Report' using the same parameter 'Date of Service' 
•    Subtract Patient Balances A/R data from the 'Total A/R Report' and it will provide accurate data on unpaid insurance charges

These reports should be run twice a month and provide information as to which insurance companies and patient charges are not meeting timely adjudication.

Tell Us: How often do you conduct insurance follow-up? Is it on your top priority list? 


Questions? Contact Richard @ Rtamburello@e-urs.com 

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.