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5 Things Billers Do to Save You Time


Medical billers provide many services. They check eligibility, verify coverage, submit claims, follow-up on denials, follow-up on rejections, post-payments, and report on the financial health of a practice.

But what kind of impact does a biller have by taking on these roles? The answer to this question depends on whether you see time as an asset. We certainly do, so here is the impact a biller can have on your time by doing 5 key billing tasks.

1. Denial or Rejection Follow-Up (1-2 hours a week)

A denial or rejection happens when key information is missing from a claim. Whether this be the ID number, Group number, Date of Birth, etc. The biller's job in this case is to look at the claim that was submitted compared to the ID card and demographic information and rectify the change.

This is a highly detail-oriented task that can take a while. This is a task that usually takes between 1-2 hours a week. The time on this task can vary depending on the thoroughness of the eligibility and verification checks.

2. Eligibility and Verification of Coverage (3-4 hours a week)

When there is a new client and before every session, the biller should be checking the patient's eligibility and verifying coverage. This is where the biller spends most of their time on the phone with payers tracking down your patient's information.

This is a critical step in reducing rejections and denials because if you have a clear picture of their insurance plan you will know what the client owes and what insurance will pay. If this step is missed or done poorly, you will have more work later.

3. Submit Claims (~1 hour a week)

Of course, if you don't send claims to the payers you certainly won't get paid. This step doesn't take a ton of time. Normally, if you have done the work in obtaining the correct documentation and entering it into your EHR then submitting claims shouldn't be an issue.

However, if information is entered correctly in this step you will end up with a rejection and will spend more time in that step.

4. Post Payments (1.5 hours a week)

When you successfully send a clean claim (i.e. a claim with no issues) you will get paid! But now you have to assign the payment to a patient and date of service. This can take some time because payers will send one big check that applies to many dates of service.

So reading and understanding the EOB or ERA is the real time killer here, but it shouldn't take more than 1.5 hours in a week.

5. Financial Reporting (2 hours a week)

Finally, the biller should be providing financial reports that assist the practice owner in making strategic decisions for the practice. This can include: margin analysis, days until the claims pay, rejection rates, denial rates, aging rates, percentage outstanding

This reporting should be accurate so as to help the owner understand the financial health of the practice and what needs to be done to mitigate risks of the enterprise.

Conclusion

Overall, the mental health biller should be able to save you anywhere from 8-10 hours a week. That is an entire day! That is a day you could have off, spend in more sessions, going on vacations, reading, writing, coloring, or any other activity you wish. This is an incredible asset to you and your practice and your bottom line!

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