Reviewing Your Billing Process can be good practice

When was the last time you took a good look at your billing process or your day-to-day practice management routine? Let’s face it, medical billing can be tedious and time-consuming, but with a few simple changes, you can save time, avoid errors and make sure you claim everything you’ve earned.

We’ve pulled together some tips to help.

Don’t leave premiums on the table

Billing omissions and errors are a common reason physicians miss out on income. Here are some of the most overlooked areas when it comes to billing:

• Off-hour premiums
  If you provide care outside of regular office hours – such as evenings, weekends or statutory holidays – you may be eligible to bill additional premiums. These are designed to reflect the added disruption and demands that come with working outside standard hours.
• Complexity premiums
  Many patients have multiple health conditions that require extra time, coordination and attention. In these cases, you may be eligible to bill additional premiums that reflect the added complexity of care.
• Special visit premiums
  In some provinces like Ontario, special visit premiums work like bonuses added to your regular fee codes and can boost the value of your claims – especially if you have certain specialties or if you’re working evenings, weekends or holidays. To take full advantage, it’s important to pay close attention to the rules around timing, coding and service location.
• Rural and remote practice
  Physicians working in smaller or more isolated communities often face unique challenges, and rural premiums are designed to help recognize that. Some provinces even offer additional retention incentives to encourage long-term service in these areas – so it’s worth exploring what might be available to you.

Review your billing practices

Reviewing your billing practices can help ensure accuracy, maximize your compensation and streamline your workflow. Here are some key steps to keep in mind when refining your process:

• Accurately document patient encounters
  Make sure you note the time and location, and whether the encounter occurred on a weekday or weekend. If you’re not billing immediately after the patient visit, it’s helpful to add comments to your notes that will remind you to apply relevant premiums.
• Choose the right billing system
  Selecting an efficient billing system can make a big difference in improving accuracy and saving time. Many billing software platforms now offer features that prompt you to enter specific codes, suggest premiums based on the information you input, and even automate or flag relevant codes.
• Leverage billing templates
  Templates are great for grouping codes, premiums and modifiers together. They automatically suggest the right codes when you bill, reducing the chance of missing out on extra compensation. You can customize templates to fit your practice, keeping your claims consistent.
• Have a plan for handling rejected claims
  Effective billing also means knowing where to get support when needed. Who handles rejected claims in your practice? Is it your responsibility, or would it make sense to outsource? Not following up on just a few rejected claims can cost you the same as hiring a professional service. Having a plan for rejections helps ensure you’re not missing out on payments and keeps your billing process on track.

Capture all your eligible billings

Many physicians miss out on income simply by not capturing all the compensation they’re entitled to. Here are a few commonly overlooked billing opportunities to keep an eye out for:

• Physician-to-physician consults – Quick phone calls or e-consults often go unbilled, even though most provinces allow you to claim for them. These small payments can add up over time.
• After-hours and weekend work – Some contracts define specific working hours (like 7 a.m. to 5 p.m.). If you’re working outside those hours, you may be eligible for extra compensation – be sure you’re billing for it.
• Private or specialty insured claims – Encounters with patients covered by programs like WorkSafe, Blue Cross, Federal Inmate or UHIP might not fall under your usual billing structure. These encounters often need to be billed separately, so it’s worth reviewing your agreement and consider using specialized billing systems to handle these claims efficiently.

The bottom line

Taking the time to understand where income might be slipping through the cracks helps ensure you’re fully compensated for the care you provide. With the right tools and best practices, you can streamline the billing process and make sure you’re claiming fully for your work – with fewer headaches and a healthier bottom line.

We’re here to help

Speak with your financial professional or an RBC Healthcare Specialist.