How Hidden OB-GYN Billing Errors Are Quietly Costing You Millions Each Year

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  The Silent Revenue Leak in OB-GYN Practices Most OB-GYN practices don’t realize they’re bleeding money. Not in dramatic, headline-grabbing ways, but quietly, steadily, month after month. The phones are ringing, appointment slots are full, deliveries are happening, and yet the numbers never seem to match the effort. Sound familiar? This is often the first sign of hidden OB-GYN billing errors working behind the scenes. These errors don’t announce themselves. They don’t crash your systems or send angry alerts. Instead, they slip through claims, hide in coding nuances, and quietly shave thousands—or millions—off your annual revenue. OB-GYN billing is uniquely complex compared to other specialties. Between global maternity packages, split billing scenarios, high-risk pregnancy coding, and ever-changing payer rules, the margin for error is enormous. A single missed modifier or incorrectly bundled service might seem insignificant on its own. But when repeated across hundreds or thousand...
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Guidelines for Reviewing your Billing Manager’s Performance

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Billing Manager's performance goals and objectives to elevate job satisfaction and productivity. Billing Manager SMART goals to achieve success! Conducting performance analysis has been an age-old practice by many businesses worldwide. However, we come across many such physicians, solo and group practices, who do not feel the need to have any assessment and review done for their billing or accounts manager’s job. This can give rise to many of the following problems that are experienced:

  • A billing manager does not have his/her clear statement of criteria for performance. In such situations, the billing manager puts forth criteria that seem good enough for the entire billing team. The problem is, there may be some area that needs the physician’s attention, which is many a time neglected. This results in a lack of oversight regarding billing and collection activities- which is the main lifeline of the practice.
  • Secondly, a physician does not have any clear idea of the manager’s job. For instance, we have seen physicians who reviewed their EHR without any consent and involvement of the billing manager. The possible integration of the EHR systems into the A/R system coveys a high priority in the investigation. Hence the billing manager should be a part of the study even if he’s not heading it.
  • Many a time, the physician’s attitude is, as long as the practice is performing well, the billing manager is assumed to be functioning properly. But when this is not the case, the physician will likely blame the billing manager. In group practices, it is seen that different medical physicians have different interpretations regarding the manager’s performance.

The First Important Step

Are all of the billing guidelines relevant to your billing manager’s position? Both practice physicians, as well as the billing manager, should spend time reviewing the guidelines.  For instance, in many smaller practices, the billing manager does an annual budget. Again, some smaller-practice managers are very much intricate in negotiating with managed care plans. And in a few practices, a part-time bookkeeper or even a practice owner’s spouse, has the accounts payable work being done. Therefore the guidelines should be modified, as seen fit for your practice.

The Advantage For Billing Managers

Billing managers will find this type of evaluation very useful for their work. First, they can get a better picture of goals related to each of the many tasks in the manager’s job. Second, these guidelines can be used for self-evaluation. Third, they can feel comfortable that their physician bosses will use the same criteria in evaluating the manager’s performance.

Physicians Involvement

Practitioners and hospitals should closely review and learn the guidelines. Then, in concurrence with the billing manager, they should modify any of the required guidelines for their practice. Once that agreement has been negotiated, it would probably be feasible to consider an initial evaluation in three to four months. Subsequently, it could be done annually.

Physician Involvement in the Manager’s Review

In any group practice, every physician should be provided with an evaluation form to review. In group practices, one physician should be the adviser of these evaluations. The purpose of the review is not to provide a progress card. Rather it is, first, to understand those tasks that are “meeting goals” and “better than goals.” These merits are acknowledged and commended to the manager. Lastly, notable attention should be addressed to any tasks not meeting the goals. These things need a very close study. The physician should aim for answers to help solve the low-performance tasks.

To know more about Guidelines for Reviewing your Billing Manager’s Performance, click here: https://bit.ly/44YCXuk Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

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