MHM was recently engaged to review the billing process of a hospital with a remit to find out why insurance companies weren’t paying.
One company was proving to be a problem and an analysis of the invoices soon identified why. This company required invoices to be sent on-line.
Except the invoices were inaccurate with, for example, the patient’s policy number being wrong. The invoices could not be submitted on-line for the details were wrong.
Instead, they were put in a “holding” pile.
To resolve the problem, it was vital to make sure the details were correct.
That was the cause of the issue.
Or was it?
It turned out medical secretaries thought the receptionist was responsible but the receptionist thought the medical secretary was responsible.
Then both claimed the person who raised the invoice was responsible. The reality was nobody was responsible.
The holding pile was greater than the value of daily outpatient appointments and it was growing.
The receptionist obtains the details. She then checks them. The medical secretary ensures all are recorded accurately. She checks them again. The person responsible for medical invoicing highlights ANY which fail.
The holding pile is now less than 1%.
Is this overkill?
Cash input from this ONE insurance company has increased by 160%.
It’s not overkilling at all.