Every job comes with a description. I can’t say that no two are exactly alike, but I can say the you could find the definition of the janitor’s position at 1 company completely different than that of the janitor’s position at another company. So it should come as no surprise to you that it is more than a difficult task to define the professional scope of a medical biller. Rather than sit here and list all of the things both you and I (think) know a medical biller should do let’s talk about some of those things that you may not be doing but should focus on.

Is Customer Service Your Job?

YES! The customer is always right, right? Well to a certain extent. One thing is always true though… whether they are right or wrong it is your job to serve them. While reading a recent book The Customer Rules, a book about the nations best customer service companies, I realized that the focus of your business can sometime get lost in the fear of assuming liability. But we need not let that fear push customer service outside of the scope of all of our employees job descriptions.

Medical billers are customer service reps. They are here to do data entry, submit claims, post payments, and most of all serve the customer.

You will undoubtedly receive a request at some point from either a patient or a physician that will fall outside the focus of your day to day activities as a biller, but it is still your job to assist them. The answer I don’t know, or that is not my job is never suitable. Although it may not be your job or you may not know you are still responsible for knowing where the answer can be found.

If you receive a question from a physician about credentialing you should NOT give him advice on credentialing, you are not a specialist in that field, but you should know the person in your office that is. Forward the question to your specialist and have them contact the physician with the answer.

When a patient calls and asks if their physician is in network there is no way for you to know the answer, specifically when contracting in involved. But you should be able to give them the number to their insurance company that has access to the information needed to answer the question.

Assuming liability and taking risk is something your employer does not want you to do, but ignoring client requests because you feel that it falls outside of the scope of your job is something that is also frowned upon. It is time to realize that your job as a medical biller expands past just billing and into the field of customer service. You will always have to expand your knowledge base and are expected to be able to serve the customer whenever possible.

Adam M.

A recent discussion on the Medical Biller’s Forum in which I had a pretty good debate about the scope and responsibility of a medical biller has inspired me to write this post. Be sure to check out the boards and join us for more medical billing fun.

Using your billing company’s collection agency is not a conflict of interest.

That is unless you don’t trust that your billing provider is collecting as best as they can. If that is the case then I feel that you already have an issue that needs to be addressed.

It has always blown me away that having your medical billing company’s collection agency be the primary collector of your bad debt may be a conflict of interest.

The relationship between physician and medical billing provider is one made on trust. You are entrusting them to handle your patient information, to correctly file your claims, collect your money, and distribute your revenues. If the bond is not strong enough to hold the belief that your billing agents are effectively collecting in a timely and effective fashion, it shouldn’t be a question of whether you should use their collection agency, but whether you should be using them at all.

You should Profit Using Your Medical Billing Company’s Collection Agency

Using a collection company that is a sister company, or part of the same billing company that you currently use will increase your collection rate. Why? Because the company will have better communication with the billing provider and better availability of information.

You may not believe me, but think about the last time you tried to get access to another company’s data. Was it easy? Probably not. If you were connecting to a computer system you had to get forms filled out, approved, and then you had to have IT set up the account and you had to be trained on how to use the system. Even in a best case scenario you are looking at day or two before you can even think about accessing any data.

If you are simply requesting information over the phone or via fax, an outside collector doesn’t know your billing agencies employees or who is in charge of what data. They don’t know the company terminology. E.G. What is the difference between a claim and an invoice. To them that question may mean nothing, but to the billing agency it could be the difference between two major reports.

Reducing the amount of red tape that needs to be met in order to collect data and increase the speed of AR is your ultimate goal because it increases the likelihood of you being reimbursed for your services. So in my opinion not using your billing company’s collection agency is a conflict of interest.

- Adam M.

P.S. This post comes before our next service post that will be introducing our sister company Custom Collections Services, Inc. Many of our clients use our service coupled with another company and we have found time and again that when exceptions in the collection process have occurred they have been able to handle them quickly and responsively because of the ease of communication.