Thursday, December 9, 2010

Billing backlog, collection backlog, posting backlog – what is the right option?

There is no “cookie cutter” solution because the factors contributing to processing backlogs vary. Here are just a few:
  • System conversion
  • Limited labor pool
  • Space constraints
  • Volume increase
  • Training deficits
  • Ineffective work flow design
  • Change in payor requirement
  • IT problems

The first step is to understand the root cause of the backlog and establish (a) an acceptable timeframe for resolving the backlog and (b) a mechanism to prevent recurrence. The result is almost always a determination that part of the game plan should include additional resources. That is when the question of options becomes critical. Conventional options have summarily included:

  • Hire more staff and accept the time required to train them to the point where they are effective
  • Outsource to a vendor with a remote processing venue
  • Bring in skilled temps (interim collector, interim biller)
  • Some combination of the above
There is another viable option not mentioned above that is very effective – REMOTE AR SPECIALIST. This would be a highly skilled, experienced collector, biller or insurance follow-up person(s) that would work from home with access to the provider system. Typically, this resource would initially work at the provider site for a short time getting familiar with the systems, people, policies and other critical orientations. Work standards would be established and the AR SPECIALIST would then work from home, saving travel cost and eliminating the need for work space at the facility. This very contemporary approach is available through Nearterm Corporation and has worked very well for many provider organizations.