A. Billing tools are available in abundance, but it’s imperative to find the solution that meets your internal needs. Only you know your team’s capability—daily load capacity, how much training/retraining is necessary and what their internal billing knowledge currently is.

The human component of billing accounts for 80% of your revenue cycle capability. The other 20% lies in the tools utilized for claims creation and accounts receivable tracking. These tools can be fully integrated into one business management solution or can be separate solutions tied together.

Manual processes leave opportunities for missed revenue. Re-billing is a time-consuming process with many elements to manage, such as equipment pickups, patient compliance, end-of-rental period, prescription refills, and CMN management, resulting in many opportunities to miss something. Another common pitfall is the use of tools like same or similar, eligibility, and PECOS verification that are not tightly integrated in your system. This creates opportunity for error in the manual transfer of information.

Finally, a system that is too difficult to manage because it’s too complicated, hard to learn, or requires excessive time from initial training to proficiency, brings additional opportunities for team process failure.

Automation is the key to successful claims management and maximized revenue. Look for a system the guides you through the billing process rather than one that relies on your inputs to function.

Ted Jones is CEO of bflow Solutions. Reach him at [email protected].