Maximizing Efficiency and Productivity with the FTE Model for Medical Billing Services

By now, we know that the healthcare industry’s reimbursement isn’t going to stay as it is. The changes are frequent and continuous with the constantly reforming healthcare industry, necessitating the need for constant monetary vigilance amongst medical practices. Amalgamating with billing professionals has been a good option for most, especially for those who have not gotten a billing department up and running in their healthcare business, which means most of the billing endeavors would be taken care of by an outsourced billing company and the providers would go ahead with what actually matters most to them - patient care.

To maximize efficiency and productivity, a medical billing company must:

1. Increase revenue

2. Reduce the denial rate

3. Ensures submission of clean and error-free claims

4. Optimize the revenue cycle

5. Speed up the payment cycle.

What is FTE in Medical Billing Service?

The ratio at which the total number of paid hours during a period like part time, full time, or contracted by the number of working hours in that period of the working week days, i.e., Monday to Friday.

The ratio units are FTE (Full Time Employment) units or comparable employees working full-time. This means one FTE is equal to one employee working full-time.

Working of the FTE Model:

Step 1: The client relationship manager and healthcare facility meet to discuss the best suitable option for the patient.

Step 2: Complete RCM and workflow analysis is done for future strategy.

Step 3: The hourly or monthly FTE fee is decided.

Step 4: Productivity is increased when an account manager manages an individual portfolio.

Step 5: Hassel free replacement of FTE if required.

Maximizing Productivity with FTE:

1. Allocation and Management of Services:

To handle the patient, the healthcare company takes services based on the availability of the workforce. Hence, productivity can be increased by analyzing the service requirement and thereby estimating the number of FTEs required.

2. Adjustment of Resources:

Resources can be adjusted according to the shift in priorities. Full-time medical billers and coders

can be adjusted accordingly as per work commitments. FTE helps in foreseeing the uncertainties in responding to the shifting priorities.

3. Budget Prediction:

The cost of a medical biller and coder varies according to the title, role, and experience. Hence, they have a cost to the healthcare company. The ones with more experience have to cover more ground in less time, and vice versa.

4. Other Benefits:

• Understand role-based capacity
• Insufficient or overstaffing should be avoided
• Operation cost reduction
• Stability of budget in terms of operation
• Quality Audits
• Periodical Reporting
• Dedicated Accounts Manager

Maximizing Efficiency with FTE

1. Analysis and Causes of Claim Denials:

With efficient FTE management of resources, the root cause of the denial of a claim is identified and preventive measures are taken.

2. Eligibility check:

The majority of the claim denials are due to the eligibility and process of RCM; hence, the hiring of efficient and trained FTE will minimize the denials and result in maximizing the efficiency of the medical billing process.

3. Reviews and Coding:

Efficient and trained FTE will lead to the proper medical documentation, billing and coding according to the standards of Medicare & Medicaid program.

4. Posting of Payment:

Check for patient payment and insurance from ERA. Showcase the financial image of a medical practice by showing the insurance payment in the EOB.

5. Reimbursement of Claims:

The denied or rejected claims need to be followed up on and reopened in order to rectify the errors and process for 100% reimbursement from the insurers.

6. SOPs Application:

EFTs that are trained to maintain standard coding, follow insurance guidelines, and follow SOPs result in fewer claim denials and maximize efficiency.

7. Reduction in A/R:

Workflow management leads to timely follow-up on claims within 21 days from the submission date, which helps reduce the days in A/R.

Overview of FTE:

Full Time Equivalent (FTE) model For Medical Practices is a concept used for measuring the workload of an employee in a company. It generally comprises medical billers and coders in a healthcare company who work either full-time or part-time and are not on the company payroll. They smooth the workload by efficiently managing the data and RCM process. They are the outsourced medical billing team, which works with the in-house medical team to process the medical billing system.

An effective FTE results in:

1. Overall operational cost reduction
2. Smooth functioning of the billing process
3. Reduction in coding errors.
4. Reducing the claim denials and rejections.
5. Patient satisfaction and retention
6. Increase in the revenue cycle
7. Performance management.
8. Workload management
9. Workforce Management

Info Hub Consultancy Services is a leading professional medical billing company in India that offers various pricing models to suit your practice needs. Our FTE model with a dedicated team of medical billing and coding experts is committed to providing comprehensive solutions to navigate the complex world of healthcare. Our cost-effective option ensures your operations run efficiently. Contact us today to learn more about how we can help optimize your revenue cycle management.

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