6 tips for better billing

The B-word for doctors isn’t that five-letter noun best reserved for a female canine. It’s that other word, one that’s both a verb and a noun. One that many doctors dread to think about, let alone utter aloud. We’re just going to come out and say it: Billing. “We know that most physicians struggle to keep abreast of their billing, along with all the other paperwork they have to deal with each evening,” said Sarah Wilkinson, chief operating officer at Dr. Bill, a Vancouver-based medical billing software provider. “And we also know that spouses are still the number one way that physicians get help with their billing—they just dump all that paperwork on their spouse.” While medical billing is unlikely to become less complex and tedious anytime soon, there are ways for physicians to make this dreaded task a little easier on themselves. Wilkinson and two other billing experts offer their top tips for physicians. Read: Peer reviewing doctors’ views on money 1. Start with a billing analysis A number of billing tech and service providers will offer to analyze, at no charge, your historical billing data as a first step in their efforts to win your business. Take them up on it. “Ninetynine per cent of doctors find that they’ve missed revenue opportunities—on average our analyses uncover at least $35,000 in missed billing opportunities,” said Paulo Gomes, business unit leader, billing and back-office services at Vancouver-based Well Health Technologies, which owns billing tech and services company DoctorCare. “Based on these findings, we can tell them ‘OK, here’s our plan to help you ensure you can capture every billing opportunity on an ongoing basis,’” he added. “But until you do this analysis, you have no idea how much money you’re leaving on the table each year. 2. Code as you go Take a few seconds after each patient visit to key in the appropriate diagnostic and billing codes. Doing this will spare you—or your spouse—from having to spend your evenings and weekends going over patient records, or having to sit down with your team to make sure you capture everything you and your nurse did over the course of the day or week. “If you save your billing for the end of the day or the week, you have to sift through all that patient information again,” said Gomes. “That makes you more susceptible to errors because now you have to try and remember what each patient visit was about.” Read: Cancellation of billing number restrictions for April part of ‘important progress’ made in Alberta talks Adding billing codes at the end of each visit can also help with patient notes, said Dr. Stephanie Zhou, an addictions physician at Toronto’s Sunnybrook Health Sciences Centre who teaches billing to University of Toronto medical students. “Sometimes I don’t have time to finish my notes after each patient so I put in the billing code instead,” she said. “When I go back at the end of the day to finish my notes, the billing code jogs my memory. 3. Bill frequently and fix errors promptly If you’re putting in diagnostic codes as you go (see tip #2 in case you’re scanning this article), then you should be able to submit your claims to the health ministry daily or weekly. Submitting frequently and promptly will also help ensure that any errors or disputes come back sooner, making it easier to recall details of the visit in question. “And make sure you’re managing and fixing errors promptly,” said Gomes. “They can turn into a real time sink if you don’t tackle them on a regular basis. And when errors go stale you can end up re-submitting errors with more errors because a certain deadline has passed already. 4. Make sure you’re using up-to-date codes Still plugging in codes from memory? Forget about it. Wilkinson at Dr. Bill said you’re likely losing dollars by relying largely on the frequently used codes you’ve committed to memory. If you’re using a written reference, make sure you add in new codes as they come in. Read: Alberta physician charged with allegedly over-billing the province between $3.5 million and $4.1 million Ideally, however, you should be taking advantage of existing billing technology that comes fully loaded with billing codes and updates automatically as new codes are introduced. Dr. Bill, for one, is built on a “rules engine” that takes all relevant data points into account to ensure you’re billing correctly and optimally. “If you delivered a baby in Timmins (Ontario), for example, our program will find the right rural bonus code for you and append it to your claim,” said Wilkinson. 5. Stay on top of billing and program deadlines How do you or your front-office staff stay on top of all the program incentives, or stay up-to-date with each patient’s provincially scheduled tests and examinations? This is where a good billing program can really come in handy. With so many cut-off dates and billing cycles to keep track of, relying on a manual system—even one that uses digital calendars—will inevitably lead to missed deadlines. “But effective billing isn’t just about the right technology—it’s also about working with people who have the expertise,” said Wilkinson. “Physicians go to school for years to learn how to treat patients, not to do the job of accountants and bookkeepers, and people who are specialists in medical billing. It’s important for them to recognize that spending hours doing their billing is not a good use of their time and expertise, and it doesn’t help their mental health either.” 6. Know where to go for information Provincial medical association websites are great resources for billing codes and other billing-related information, said Dr. Zhou. The Ontario Medical Association, for one, has a condensed list of the most commonly used billing codes for family medicine, plus a schedule of benefits with codes for all practice specialties. “The OMA will also often post PDF handouts that focus on common billing codes in certain types of practice, like in an addiction clinic,” said Dr. Zhou. “A recent PDF handout focused on billing codes for virtual appointments.” Read: SEVEN-YEAR HITCH: Why a $146,000 fraudulent OHIP billing case that began in 2014 is still going on She also recommended joining social media groups and forums such as First 5 Years in Family Practice, whose members range from novice practitioners to veterans. “Doctors will often post here when they don’t know what to do in a clinical case, but there are also questions about what to bill in certain situations, like when someone comes in with no OHIP card,” said Dr. Zhou. “Often, a doctor with more years in practice will respond.”

6 tips for better billing

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