Five Ways to Optimize Your Charge Entry Process

By Baldwin, CPC, CPMA on May 2, 2018

The charge entry process is the most important step in the medical billing process. Incorrect or missing data can result in denied or delayed claims. Administrative costs go up when mistakes are made in this data entry step. Staff are stretched thin and managers are stressed about revenue and these levels go up when the billing process does not run smoothly.

What percentage of your bills are never collected? Consider this: If your office generates $1 million in bills and leaves just 5% uncollected, you stand to lose $50,000 per year.

Sadly, many claims are denied simply because of data entry errors, a problem that could be almost eliminated by improving the charge entry process. How big of a problem is it? Research shows statistics at both ends of the spectrum. NBC reported that the American Medical Association estimated 7.1% of paid claims contained errors. While NerdWallet found mistakes in 49% of Medicare claims. Even more alarming, Medical Billing Advocates of America and CoPatient estimate error rates to be as high as 80%. The focus of NBC’s investigation was from the patient’s perspective. Therefore, improving the charge entry process has a three-fold benefit:

  • Improves customer service by generating timely, accurate invoices
  • Increases revenue by eliminating errors and decreasing denial rates and delays
  • Optimizes staff time

How can you optimize your entry process? Here are five ways.

  1. Set a goal for same day entry.How many days lapse between the date of service and the day charges are posted to the patient’s account? Medical practices should aim to have no lag time. The longer it takes to post charges, the longer it takes to get paid. Claims should be submitted that day or within 24 hours. If it is a slower time of year, don’t wait for a certain number of claims before submitting. That will only add unnecessary days to your accounts receivable. Even for consultations, set a goal of completing encounter documentation before the close of the business day or within 24 hours.
  2. Monitor performance indicators. The first step in optimization is identifying any weak spots. Select key performance indicators, establish benchmarks and run reports weekly. Here are a few examples.
  • Missing charges: Your practice management software should be able to produce a report that identifies appointments that do not have charges posted for them. Are some appointments missing partial charges? Why? Did the employee posting the charge miss a charge mark or did the physician fail to mark all the appropriate charges? Running these reports weekly will help catch mistakes quickly and identify where there might be a flaw in the process.
  • Coding errors: Most likely, you have a coding editor. However, are you monitoring the percentage of claims that fail the editor? How much staff time is spent correcting invalid codes? An incorrect code might not get caught until the insurer denies the claim. At that point, staff time is wasted, cash flow is affected and the patient will most likely get an incorrect statement. Regularly monitoring coding errors will help you identify where the error is coming from. Is it simply carelessness? Are staff up-to-date with new codes? Is it a training issue? Is it a software issue? Keeping an eye on this performance indicator is crucial to improving the charge entry process.
  • Lag time when entering charges: We already discussed the importance of entering charges within 24 hours. Regularly reviewing a report that shows the average time between the date of service and the date the charges were posted will help you keep tabs on how the office is doing on this important performance indicator.
  1. Customize paperwork and software.Every office is different and not all medical billing software works for every practice. For example, ophthalmology practices may use fewer codes than other specialties, however “there are aspects of charge entry that are unique to ophthalmology, particularly the complex coding associated within the oculoplastic, neuro or retina areas of specialization,” stated the American Academy of Ophthalmology. Customizing printed patient forms, as well as software modules, can decrease errors and lower the amount of time staff spends on each patient. Is your software made for your specialty?
  2. Have the right staff.Multi-tasking and cross-training is good but mixing the duties of the billing process with other office work often produces inefficiencies. How much staff time should be dedicated to billing? The AAO said, “Within general ophthalmology, staff costs associated with billing should comprise approximately 5% of your income. Other benchmarks recommend one staff person per $1 million of collected income.” However, the size of your staff isn’t the only factor. The AAO also recommends looking for self-motivated problem-solvers with an attention to detail. Many specialists attest that training on-site is beneficial. So the key to hiring a great billing specialist lies more in their work style than if they have experience in your practice’s specialty area.
  1. Get started before the day of service.Preparation is key, both for the staff and the patient. New patients should get forms well in advance of their day of service. Staff should verify insurance several days in advance. By the time the patient arrives, all that should be left is to update the record with the appropriate charges.

Achieve uninterrupted cash flow, avoid rejected and denied claims and reduce the administrative time spent fixing problems by optimizing your charge entry process. The AAO puts it simply, “If you want to safeguard your practice’s fiscal health, it is critical that services are billed correctly and collections maximized.” That starts with your charge entry process.

Agnite Health LLC, an affiliate of Advantage Administration, Inc., specializes in billing solutions specifically for ophthalmology practices. Our experienced staff can help you improve your own internal team’s efficiencies or we can take on this important task for your practice so you can focus on what you do best: patient care. Contact our team to learn more about optimizing your billing process.