What are the standards for biller activity and productivity? We split our billing by alpha rather than by type of insurance. As a result, each biller works all insurance (i.e., commercial, Medicare, Medicaid, workers’ compensation) for their portion of the alpha split. They also handle all billing, follow-up, and appeals.
Answer 1: Biller productivity can be based on the average amount of time required to resolve the volume of work assigned. To calculate this time metric, first determine the average amount of time needed to correctly and accurately handle a specific type of billing, follow-ups, and denials. Times will be different for each activity. Next, track how many accounts in each category are processed per day. Work only with productive time by factoring out breaks and lunch times. Finally, compare staff to each other for similar activities. Analyze the results to see how much work is being done compared to what you expect to get done based on the time to process requirements.
This question was answered by: Sandra Wolfskill, FHFMA, director, healthcare finance policy, Revenue Cycle MAP, HFMA.
Answer 2: The Hospital Accounts Receivable Analysis by Kluwer Law provides key performance indicators and breaks them down by region, as well as bed size.
This question was answered by: Caswell Samms, network CFO, Lincoln Medical Center and Harlem Hospital, and is a member of HFMA’s Metropolitan New York Chapter.
Answer 3: Our billers each handle one specific payer and do their own follow-ups and appeals. However, if our facility had a very high volume for one payer for which we needed additional billers, we would utilize an alpha split per biller for that payer. Our production goal for follow up is usually 50-63 accounts worked per day, excluding billing claims.
This question answered by: Angela D. Hadzega, CFO, Jack Hughston Memorial Hospital, Phenix City, Ala., and is a member of HFMA’s Alabama Chapter.
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