Meet Cara Lloyd, Billing Director.
Prior to joining the Primary Solutions team, Cara spent 16 years as a provider. As the director of a provider agency in Central Ohio, Cara developed her skills in services delivery, staff management and effective leadership of the organization. Now She supervises a robust team at Primary Solutions.
After leading a team of 28 Billing Coordinators and Claims Management Specialist that process billing and track claims for over 220 agencies and independent providers. Cara has gained immense insight into the complex billing process. We asked Cara's perspective on a few items that could help provider organizations thrive. Hear from Cara as she expands on her experience as she answers the "3 Questions for the Billing Director."
Stepping out of the provider role allowed me to reflect on how reactionary I had to be as a provider. We were supporting people while they were living their life, which meant we ran into unplanned situations that needed our attention. I realized that this component made it more difficult to stay proactive in the billing process of my organization. There are simple, proactive practices providers can establish that can have a huge impact on the efficiency of their billing system. I would build these practices into my operating system.
We spent a lot of time focused on over-utilization, which I encourage people to continue to monitor; however, I wish we would have spent more time looking at where we were under-utilizing services. There were circumstances where we could have been providing more services to the individuals; but, didn't because we weren't monitoring under-utilization, as much as we could have.
Depending on the size and structure of the organization, the service manager and biller can be different people or completely different departments separated by space and management structures. There is important information that is housed in billing data that allows providers to adequately prepare for an annual meeting. Reviewing the previous year’s utilization and coming to the meeting with a clear, but flexible thought on services and amounts that should be authorized can be a huge time and money saver, in the long run. Following the meeting, I suggest using the tools available at DODD to verify the hours in the CPT and make sure you have what you need authorized in the PAWS at MSS. By doing this before the span even starts, a provider can save a lot of work if over-utilization occurs.
Of all the work providers do, billing can easily be one of the most complex processes. There are so many details to consider, quick turn-around times and a lot of room for error. Let our Billing Services Team provide you with the complete Solution.