What is a Billing System Analysis?

A practice’s billing system is just as important as its providers and clinical staff.  One cannot function without the other.  A practice cannot sustain itself, no matter how experienced and talented its providers are, without an equally experienced and talented billing division.

How efficient is your billing system?  Is it operating at peak efficiency?  How much money are you leaving on the table?  So long as the bank account is full, nobody asks the questions.  Most practices only notice there’s a billing problem when it’s so large that it cannot be ignored… and then the question arises… what else don’t I know about my billing?

As a third-party billing company, UFS has performed countless billing system analyses for practices in order to identify problem areas and propose solutions.  A billing analysis is a comprehensive review of existing systems, processes, policies and procedures, and most importantly, billing data.

How do you perform your Billing Analysis?

A Billing System Analysis is custom tailored to each practice’s needs, but they generally follow a similar approach:

  • PHASE 1 – Discovery
    • During the Discovery Phase, UFS typically performs multiple on-site visits of the practice’s facility and begins a comprehensive review of its systems, employees, and processes.
    • UFS then gains access to reporting modules and generates all necessary data.
  • PHASE 2 – Audit & Analysis
    • Throughout the Audit and Analysis phase, UFS reviews all data obtained in the discovery phase and begins its analysis
  • PHASE 3 – Reporting & Deliverables
    • During the Reporting Phase, UFS reviews the data analytics generated during the Audit and Analysis phase and creates comprehensive reports of its findings, along with identified problems and proposed solutions.
  • PHASE 4 – Implementation & Follow-Up Review (Optional Phase)
    • After UFS has concluded with its final Deliverables phase, the practice may elect to engage UFS to assist in the implementation of proposed solutions
    • The practice may also wish to engage UFS to perform a Follow-Up Review to ensure that all measures have been implemented successfully
  • PHASE 5 – Billing Management (Optional Phase)
    • Universal Financial Systems has decades of experience running and managing billing systems and teams and provides monthly management services to help keep billing systems running at optimal performance.  This would include regular check-ins with the billing team, daily and weekly reporting, as well as comprehensive billing reports monthly.

What do you look for?

During the Discovery and Analysis Phases, UFS examines and provides audits for many different billing areas, including but not limited to the following:

  • Billing & Coding Accuracy
  • Patient Intake Process
  • Eligibility Verification Accuracy & Processes
  • Account Receivable Analysis
  • Insurance Review / Payer Mix Review
  • Fee Schedule Analysis
  • Specialty Code Review
  • Reimbursement Analysis / Net Collection Review
  • Rejection Analysis
  • Denial Analysis
  • Write-Off Review
  • General Billing Process Review
  • Missing Encounter Audit
  • Superbill Audit
  • Patient Statement Process Review
  • Patient Collections Process
  • Billing System Report Review
  • Staff Audit

What are the Deliverables?

Our goal is to identify all problem areas and suggest solutions to those problems during the Reporting / Deliverable Phase.  These Deliverables may include:

  • Executive Summary of findings
  • Reports for all items reviewed in the Discovery Process
  • Analytics for billing performance metrics
  • Spreadsheets, Charts, Graphs as necessary
  • Comprehensive outline of problems found
  • Comprehensive outline of proposed solutions to problems.