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Performance Standards/Workload

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rmk123:
Revising workload performance standards for billers who handle the process from insurance verification through resolution. Tasks are not divided by person but one person performs all tasks. I have located industry standards by task which is helpful. I am challenged, though, on how to create a hybrid of this for our model. 


I have the industry standards for measuring success on the AR management/collection side. This will be coupled with the workload goals.


What are your suggestions for an effective system?

RichardP:
Are you in any position to be able to do time and motion studies?  That would be the only reliable way to collect your data (as opposed to somebody else's data).  What specialties do you handle: chiropractor; social worker; psychiatrist; heart surgeon?  How much of your practice (practices?) is Medicare? Medicaid? Worker's Comp.? HMO?  Does your doctor have a Physician Office Lab that you have to bill for?  Hopefully you get the point.  The billing work involved is going to vary based upon how busy your doctor(s) is/are, what their specialty is, what insurance carriers are involved, etc.  There is no list of performance standards out there that accurately reflects your unique set of circumstances.

Having said that, a rule of thumb is that one person who knows what they are doing should be able to handle two doctors from start to finish.  That runs more true than not for my business, and the majority of my clients have Physician Office Labs that we bill for.  We employ roughly one person for every two clients we have.  Some times are busier than others, so there is variation in the workload at times.  But we use slack times to catch up on things we maybe put off during busier times.

PMRNC:

--- Quote ---Are you in any position to be able to do time and motion studies?
--- End quote ---

Yes, I call these work flow studies. More and more companies are very successful using this method. It's one of the things I do in my consulting for larger offices. I go in and cross train all of the admin department, this way each person knows what the other person is doing, it kills a few birds with one stone in the long run if someone is out for extended period of time, work doesn't stop. It also of course increases efficiency as well. The staff really likes it too, as it gives each of them a break from their normal routine. :)

RichardP:
Just to be clear - a work-flow study is different from a time and motion study.

A work-flow study follows the work on its entire path from the time it comes into the office until the time it leaves - looking for any bottle-necks or any ways the path might be made more efficient.

A time and motion study looks at repetitive tasks and times them.  It then looks at the motions required to carry out the task and analyzes whether anything could be changed to cut down on the motions required to carry out the task.  An example of this might be having your clerk type in three weeks worth of diagnosis and proceedure codes for a specific doctor, and time how long that takes.  Then divide the time it takes by the number of fee slips to get a time-per-fee-slip figure.  Another example would be timing how long it takes someone to highlight, cut, and then paste something using the mouse (looking at range of motions).  Then time them doing the same thing using key-strokes on the keyboard (usually faster than reaching for the mouse).  When you arrive at a time-per-unit figure, you can multiply that figure by the number of instances of that task to get a ballpark idea of how long it should take to get the job done.  Folks who consistantly exceed the norm can get paid more.  Folks who consistantly fall below the norm can be replaced by those who can at least match the norm.

As I pointed out in my previous response - the norms vary, based on all the things I listed in my previous response, and more - such as specialty of doctor, type of insurance, whether the doctor does his own labs, etc.  But, if you have people working for you, and you have not established these types of norms, it is difficult to tell whether you are getting a fair level of work from your employees for a fair level of pay.

QueenAlicia:
How do you implement these studies?  Are there a bunch of charts and surveys?

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