Back in the late 90’s, New York State’s Worker’s Compensation plan announced that they were changing pay rates on most services provided to workers throughout the state. I went to a meeting about a week afterwards where people were discussing the problems they believed were coming, and wondering how they were going to submit claims.

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I said I was going to continue mailing out bills as if nothing had changed. Some of them thought that sounded strange, and asked if I wasn’t worried about getting paid properly. I said that if I noticed something drastically out of whack that I would question it, but overall, as long as we were getting paid, that was the most important thing to me.
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Most of what is done in patient accounting (aka patient financial services) is fairly simple and routine. The days of only paper claims are gone (but not totally eliminated). These days, if registration has done its job, and the departments have done their jobs, and your charge master is up to date, most of the time your billing personnel will never even see an account, let alone touch a bill.

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This doesn’t mean there aren’t complications, otherwise every single claim would be paid and there wouldn’t be a need for receivables personnel; that’s a nice pipe dream. There’s always something getting in the way of trying to bring in the money you’re owed, but for the most part you’re okay with it because it’s consistent with your norm.
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It almost seems silly to have to have a discussion on compliance, or, rather, why every hospital, nursing home, physician’s office, FQHC, etc, needs to have a compliance plan, if not a compliance officer.

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Yet, after being contacted last week about the possibility of doing a compliance review at a medical facility, having created a compliance plan for a physician’s group a couple of months ago and being reminded of what happened to a compliance officer I knew, I realize that this is a subject that not only has to be brought up again, but one that could have serious ramifications for those facilities that don’t realize just how crucial it is, and just what the heck they’re supposed to do about it.
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As a consultant, every once in a while I’m asked to come in and assume the position of interim director of patient financial services. There’s a difference between going into a position where you know you’ll only be there for so many weeks as opposed to knowing that you’re coming in as a permanent employee. […]

Here’s a common scenario played out in business offices across the country. The words are different but the issue is the same; this one is health care related. Photo by Denny Müller on Unsplash A phone call comes in and your staff person picks it up. “Hello, this is Mary. How may I help you?” […]