We recently caught up with Melissa McCormack, medical analyst at Software Advice, who reviews and writes buyers’ guides for medical billing software.
Q: How do medical billing reports improve efficiency in relation to what medical practice accountants have traditionally done?
A: It’s the automation that’s invaluable with these reports. Although some medical billing reports could technically be created manually, that kind of work requires a lot of man hours. Additionally, manual data entry and compilation will inevitably contain some amount of human error. Having software that already “knows” and stores all your billing data and can automatically compile reports on that data is hugely helpful. You have quick access to historical data, which helps you identify trends and make projections. And you have much more flexibility than paper bookkeeping or even software programs like spreadsheets that weren’t designed specifically for medical billing.
Q: How does the Top Carrier/Insurance Analysis Report help medical practitioners save time and money?
A: This report tracks charges, payments and collections of the insurance carriers that make up the majority of your practice’s revenue. The data is broken down by insurer as well as CPT code and units. This allows you to see, for example, what each carrier pays you for a specific CPT code. That can help you identify your most profitable CPT codes. Additionally, if you discover that a certain carrier pays you less than others, that’s a trigger to try re-negotiating your contract or even dropping that carrier. Some doctors are hesitant to drop insurance carriers, but experts suggest that dropping a low-paying carrier can yield savings in the neighborhood of $50,000 a year.
Q: How do these reports help practitioners negotiate prices with insurance carriers?
A: Knowledge is power. When you identify a carrier that is paying you less than other carriers for the same procedures, and you’re equipped with hard data to back that up, that gives you bargaining power—especially if the carrier knows you’re willing to drop them in order to save money.