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Optimizing Your Billing Workflow


In an effort to navigate through the many complex aspects of running a private practice, you have likely measured your documentation practices, workflows, and staff productivity. However, you may be surprised to learn that those fundamental measures of practice operations are not the only factors that directly impact your bottom line.

The reality of healthcare today is that the effort you apply on the front end of patient care is only as good as the attentiveness and accuracy that goes into your billing practices on the back end. After all, if the claims you send to insurance companies are inaccurate, there is a hundred percent chance that you will experience a delay in your reimbursement. In fact, according to an article in Healthcare Finance, claims errors can double the amount of time it takes for your claim to be processed. Think of it this way, how likely is a piece of mail going to get to its intended recipient without the correct address? That mail will continue to be returned until it contains everything the post office needs to process it appropriately. With that said, your practice's cash-flow depends entirely on the optimization of your billing workflow; sending out clean claims - the first time, every time. But before you can optimize your billing workflow, you have to understand the entire process of revenue cycle. So where does the work start?

Believe it or not, your front office staff have the most impactful role in your revenue cycle. Their ability to collect and enter your patients' demographic data with accuracy and completeness is just as important as the physician's responsibility to assign the appropriate ICD-10 and level of service to an office visit. Even the smallest of errors like a misspelled name, wrong date of birth, or a transposed insurance ID number can lead to a claim denial and ultimately slow your practice's cash flow - not to mention, it could also lead to inaccurate patient records.

What if I told you that it costs your practice $15-$25 per claim error- and that almost 80% of those errors were due to registration mistakes? The first step to optimizing your billing workflow is collecting information over the phone when a patient calls to schedule an appointment, known as preregistration. This will help to identify if your practice accepts the patient's insurance plan and also inform the patient if they should expect to pay a copay at the time of service. In addition to point of service collections, gathering identification and insurance cards, and validating the information entered establishes your revenue cycle process.

As healthcare continues to evolve and become more complex, establishing a comprehensive revenue cycle processing will certainly help you continue to navigate through those changes. The truth is, everyone in your practice has some skin in the game and spending time to ensure the accuracy of your claims is a step toward improving efficiency and optimizing your billing workflow.

Rose M. Romero is the founder/ CEO of Accredited Medical Billing Associates, a leading revenue cycle management company based in Altamonte Springs, Florida. For over 30 years, she has helped medical practices create customizable business solutions to optimize practice revenue, enhance cash flow and profitability, and increase efficiency. Visit www. or email Rose at

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