Break the Cycle of Unbilled Encounters

I want to talk about something that really irks me. In companies for many years now, often a consultant does the work and doesn’t put the work on their timesheet. Basically, you’ve got the cost and you’ve done the work, but yet you’re not getting the benefit; you’re not getting paid for it. This happens in physician’s offices when a doctor sees the patient and they don’t mark it done, or signify in any way that it’s ready to be billed. We’re seeing this a lot with different practices, that when doctors make their notes, they don’t mark it done or lock it so that the biller can bill it.

We started to show practices that they’re aging on these notes. A lot of payers have timely filing deadlines by number of days from dates of service. As we watch these notes from dates of service, they’re getting closer and closer to timely filing, so we put out a regular report that we send to the practice that shows all the notes by providers that have not been locked. We also break it down by payer and break it into buckets: 0-15,15-30,30-60,60-90,90-120. Usually between 90-120 is when you’re hitting your timely filing issues. It’s important to focus on getting your provider just to finish their note and lock it, otherwise you’re going to be writing off some unknown amount of charges that were provided but never billed, and you’re not going to get paid for them.

What does this amount to? We had a practice that had a couple hundred notes from one provider that had never been locked. What do you say to that provider? If the practice is paying that provider, then they’re not doing their work, and you’re not getting paid for the work they have done. If I were to have an employee doing a bunch of work and not billing for it, and it’s a repeated practice that you can’t get corrected, I’d fire them. On the billing side that hurts us as well, because we only get paid on what we collect.

It really comes down to the team identifying these providers and encouraging them to lock their notes, and to tie compensation back to what they get to what they get paid verses salary. We find many practices that are in this situation. A practice we took over not too long go ended up having notes that had not been locked, finished or billed from 2017, all the way through April 2018, and you know they’ve lost a lot of money there.

It’s important to get everybody on the same page to get the notes locked in a timely manner. You have to get the claims created and submitted timely so that you at least pass that first hurdle. At RCM360 we can do that for you. We can’t lock the note, but we can continue to push and report for you which notes that are nearing timely filing and help you get those billed. Our average turnaround for client creation once locked is under a day. We get those claims out as quickly as possible to capitalize on as much as we can to get that money for you.

Think about it: how much are you losing because of timely filing? Why is that? Is it because the provider hasn’t finished their note, or because your biller hasn’t been creating notes or coding them in a timely manner? Identify the issues, and take steps to resolve it. Get all the money that you’re entitled to, because after all you did all the work to get it.