By Andrea Stark, MiraVista, LLC

As a consultant working in the reimbursement sector of the DME industry, I routinely visit clients to perform assessments of their accounts receivable (AR) departments. Like most business owners, these DME suppliers are looking for ways to create a more targeted workflow and improve billing efficiencies. While each case is unique and each client faces their own individual challenges, the one thing I’ve consistently found is that the majority of DME suppliers are underutilizing a valuable tool almost every one of them has at their disposal: Microsoft Excel.

I can’t tell you how many times I’ve met with a client frustrated with the limitations of their current billing software. True, most commercially available software can create standard AR reports (i.e. an Accounts Receivable By Payor report), which aggregate tens-of-thousands of records and provide an agreeable snapshot of current AR standings. However, these reports give little guidance on the type of information many business owners and billing managers base decisions on, such as quality of sales, effectiveness of collections or the cause of recurring problems. But with Microsoft Excel, this is exactly the type of information you can extract. 

With a little know-how, suppliers can use Excel to: export and manipulate large quantities of raw data, analyze data to evaluate performance and problem areas, and easily map information that would otherwise have to be manually looked up and entered. 

In just a moment, I will provide a few examples of how our DME billing company, ClaraVista, utilizes Excel to produce targeted results with little effort. However, I know it will not do any good if you are unable to take this information and apply it to your own business. That’s why we’d like to go beyond just telling you what you should be doing and actually show you how to do it.

On Wednesday, June 23, 2010, MiraVista will be holding a live Excel webinar tutorial, entitled: Maximizing AR Efficiencies through Excel: Your Receptionist or Delivery Tech Could be Your Best Data Analysts and we encourage you to come! The webinar will start at 2pm EST for Excel 2003 users and 4pm EST for Excel 2007 users.

During our Excel Webinar, Derrick Stark CPA, CVA, will use sample reports relevant to the DME industry to show you how to fully utilize the program to strategically analyze, sort and format data in your own sales, collections and AR reports. Attendance is being offered at a discounted rate of just $49 and seats are limited to the first 50 participants. For registration and payment information, please call: 803.462.9959 x 252.

With that said, let’s move on to some examples of how we use Excel at ClaraVista:

Average Age of Claims By Procedure Code

As our account managers are combing through vast amounts of AR data, it is helpful for them to analyze collection trends in regards to certain procedure codes.  For example, if we see average times increasing, it may indicate: a problem with a specific client’s procedures for providing the service, a processing issue with a specific insurance company, or an increased level of scrutiny by the payor.  We also use this analysis as a monitoring component to our own quality control protocol. 

We start, by exporting our data to Excel and sorting it by procedure code. We then use Excel to quickly calculate the average age of claims by each procedure code. By running this query over subsequent months and comparing the results, we are able to identify the trends which our staff should focus on to perpetually improve collection results.

Mapping

Another great feature of Excel is that it allows you to easily map information that would otherwise have to be manually looked up and entered.  For example, based on standard prefixes associated with Blue Cross/Blue Shield policy numbers, Excel can determine the appropriate Blue payor (e.g. Blue Cross of Alabama, Blue Shield, etc).

At ClaraVista, we maintain a spreadsheet in Excel that correlates standard policy number prefixes to specific payors, and input all of our transactional data, including policy numbers, in a separate spreadsheet. We then have Excel lookup the proper payor based on our Prefixes spreadsheet and identify any records where an incorrect payor is being billed (based on the policy number). The results allow our billing staff to quickly identify any claims that are not paying due to data entry errors related to the payor information.

Missing/Expired Authorization Analysis

We also use Excel is to avoid denials related to missing or expired authorizations. Through a series of simple formulas, we can quickly create custom reports that identify those patients for which there is no authorization at all or the expiration date expires within the next 90 days. This data allows us to generate quick work lists for maintaining current authorizations.

You Too Can Benefit From Excel!

With fee schedule cuts across the board, tighter payment regulations and ever changing policies, you have to maximize your resources and harness the power of data management.  All billing software programs are built on database platforms, and most allow for some level of data export.  By understanding how to organize exported raw data and manipulate it in Excel, you can produce strong returns on a modest effort.

By Andrea Stark

“An average day at a provider’s office can include meet­ing with customers, developing prospective referral sources, educating physicians, reviewing financial information, bargaining with vendors, and participating in the latest legislative soap opera. With so little time for billing and collecting payments for services provided, extreme efficiency in managing accounts receivable is paramount. Thankfully, readily available spreadsheet and database programs can be used to create a more targeted workflow, allowing billing personnel to focus on areas that are most likely to yield quick cash flow.

Commercially available billing software is often limited to the standard reports deemed important by computer programmers. For example, an accounts receivable by payor report provides a nice aggregation of tens of thousands of records, along with an agreeable snapshot of where accounts receivable (AR) stand. It gives little guidance, however, as to the quality of sales, effectiveness of collec­tions, or the cause of recurring problems. To get this guid­ance, a provider usually allocates manpower to manually analyze the reports, or asks the software vendor to create custom report queries within the software. Both are time-consuming and costly. Instead, you can directly access thousands of records and create simple tools in Excel that point billing personnel in the right direction….”

The complete article, which includes step-by-step instructions and diagrams on how to manipulate data in Excel to your advantage, can be found here, in the October 2008 edition of HME Today .