Read this Book: The Physician Billing Process

December 5th, 2007 by Dan Rodrigues

There is so much to learn about the business of healthcare.  One of the ways I try to keep up is to spend a ridiculous amount of time reading anything and everything I can get my hands on.  In fact, I just finished reading arguably the best book I’ve ever read on the subject.  Let me tell you why you need to buy and read this book today.

The Physician Billing Process The book is entitled “The Physician Billing Process: Avoiding Potholes in the Road to Getting Paid” written by Deborah Walker, Sara Larch, and Elizabeth Woodcock, three accomplished practice management consultants and speakers.  The book is published by the Medical Group Management Association (MGMA) and Medical Economics magazine has hailed the book as “A bible on the science of reimbursement”.  One of the reasons I originally picked up the book was because I recognized the name of one of the authors, Elizabeth Woodcock, who had given a benchmarking seminar I attended in September at the Healthcare Billing and Management Association (HBMA) fall conference in Las Vegas.

Unlike other practice management books, this one focuses exclusively on how you can manage your practice to ensure you maximize reimbursement and get paid for your services.  Most of the book analyzes each stage of the revenue cycle process including previsit, patient check-in, charge capture, claims, payment posting, insurance follow-up, denial management, and patient collections.  The remainder covers special topics including rightsizing your staff, using technology, in-house vs. outsourced billing, reporting, and compliance.

Here are a few of the topics I enjoyed most:

First, each chapter includes performance benchmarks collected by the authors from a study of real practices.  For example, the authors say the optimal staffing level for all back-office billing functions is approximately one staff member per 10,000 claims.

Second, a major theme throughout the book is getting things right the first time.  To drive home this point, chapter 1 provides a worksheet that helps you calculate how much denied claims cost you and shows you how some practices spend more money resolving denials than they collect by resubmitting the claim.

Finally, chapter 13 provides a number of sample reports you can use to manage and analyze your revenue cycle.  I’ve seen a lot of report – from customers, experts, even competitors – but I haven’t seen a set of reports that are as concise, yet insightful as those the authors have provided in this book.

This book has something to offer for everyone involved in a physician’s revenue cycle.  If you are new to billing, this book will give you a fantastic introduction to the process.  If you are veteran guru, use this book to compare your business to industry best practices and performance benchmarks.  You can pick up a copy of this book at the MGMA store by clicking here for the catalog page for The Physician Billing Process.  It costs $65.00 for members and $105.00 for non-members.  Buy it for yourself, or better yet, buy it for your entire staff.  That’s what I did!

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