Data Entry Errors Are Costing This Practice Money: What’s Causing This Mess?

BULL’S EYE CARE OWNER Dr. Pickett joined his monthly meeting with office manager Alice to go over anything in the practice that may need his attention. He began, “Alice, our CPA mentioned that our accounts receivable average is higher than it should be. I’d like to task you with finding out why so we can reduce these margins.”

“Interesting. I will dig into this and report back to you when we meet next month,” Alice replied.

Alice was somewhat perplexed — though there are some newer employees, for the most part the team is experienced, and the practice operates like a well-oiled machine. Wasting no time, Alice went to the billing specialist, Kanisha, to begin her research.

“Hey Kanisha, I need your expertise to help look into something for Dr. Pickett,” Alice started.

“Sure, what are you looking for?” Kanisha replied.

“Our CPA advised that our AR average is much higher than it should be — Dr. Pickett wants a reason why so we can work to improve it,” Alice answered.

Kanisha took a deep breath and thought about her response, “Well… If I had to say why, there are several reasons.” Kanisha continued, “Do you have a pen?”

“Yep — go right ahead, I’m all ears,” Alice replied, intrigued.

“I think it’s worth mentioning that we have gotten busier over the years, so our claim volume has definitely increased. I understand how the revolving AR balances could have crept up.” Kanisha added, “And while I am quite experienced, I am still only one person.”
Alice nodded.

“I would say my number one battle is fixing staff errors prior to submitting the claims. To be frank, the front desk and opticians have gotten incredibly sloppy about data entry, and every single claim has to be overly scrubbed and corrected.” Kanisha continued, “Even after correcting so much, many claims still get denied for simple data entry errors. It’s a balancing act of either spending my time cleaning up before submitting or submitting to see what gets paid and using the time working denials.”

“I understand.” Alice added, “I can see where that would happen — those people rush to get through their stacks of charts and orders, so they make mistakes.”

Kanisha replied, “The busier we are, the more errors they make, and it bottlenecks at my desk.”

“Okay, what do you recommend to improve this?” Alice asked.

“Improving everybody’s data entry accuracy would be a start, but I think there are too many variables, and it wouldn’t be enough.” Kanisha continued, “I’ve brought this up with Dr. Pickett before and presented a billing EHR add-on as a solution.”

Alice replied, “Oh, interesting, I hadn’t heard. How could this help?”

“For one, it scrubs claims and flags errors. It also monitors claim aging to ensure denials are resubmitted in a timely manner so our reimbursements aren’t delayed, we wouldn’t have to change clearinghouses, and many other features…” Kanisha responded.

“It sounds like this could be a great solution — why have we not adopted this tool? Is it expensive?” Alice asked.

“It would pay for itself almost immediately and it’s far less of an expense than hiring another person.” Kanisha looked at Alice, “BUT Dr. Pickett absolutely does not want a third-party having access to our patient and AR data.”

The expression on Alice’s face changed as they both realized this may be a bigger challenge than they originally thought.

Melissa R.
Port Orchard, WA

This situation involves both staff practices and system issues. Staff must take time to ensure claims are correct and complete before submission. Using an EHR that automatically detects and flags errors prior to sending is an excellent way to reduce denials. Additionally, giving each employee time “off the floor” for uninterrupted administrative work could significantly decrease mistakes. The CPA could have identified this problem sooner by checking in with the doctor monthly. Though Dr. Pickett’s concerns about third-party access to patient and financial data are valid, robust IT support, strong cybersecurity, and reliable firewalls significantly reduce risk.

Daniel A.
Port Saint Lucie, FL

The doctor’s concern is valid, however if they are using a cloud-based EMR, the data is already vulnerable because everything is hackable. The Social Security office and U.S. military have all been hacked. So go ahead doctor and get the billing software for your EMR, you will be happy that you did.

Whitney H.
Missoula, MT

This appears to be a multi-faceted problem. Firstly, data entry is sloppy. Secondly, the practice is busier, which increases the rate of errors. Thirdly, the biller is overwhelmed by the number of claims needing to be filed and mistakes needing to be fixed. Finally, the doctor is reticent to use a billing add-on because of third-party access to patient information. This practice has two choices: Hire someone to help the biller or use a billing add-on to help scrub and fix claim errors. The doctor has to decide if he is more comfortable paying more for a second biller or allowing the EHR add-on access to patient data. This could have been prevented by having a discussion regarding high AR averages and addressing the need for either a technological intervention, making the biller’s job more streamlined, or the addition of another staff member.