It's a war out there in the trenches of physician practice billing, say billing managers and consultants.
And the rules for conducting that war have grown ever more complex.
Enter two veterans of the billing battlefields, Scott Williams and Elizabeth Woodcock, who met while managing the billing offices of the University of Virginia's 400-physician clinic, the Health Services Foundation.
Williams, 37, now directs Duke University's Private Diagnostic Clinic, a 900-physician practice in Durham, N.C.
Woodcock, 30, is director of knowledge management at Physicians Practice, a practice management publisher, and is an Atlanta-based independent consultant with MGMA Health Care Consulting Group.
Their session, titled "Benchmarking the Billing Office," will be held at 3: 45 p.m. on Monday, Oct. 16.
"Just in the last five years physicians have really had to fight with insurance companies to get paid," Woodcock says. "It is a war. Five years ago physician billing was an interesting subject that nobody paid attention to. But now it's a huge deal because it takes so many resources."
Williams describes the "nuts and bolts" session as a way for billing managers to explore the latest industry survey information and compare their performance, priorities and spending.
Williams and Woodcock say insurers operate under different eligibility rules, employing various software systems with numerous standards for reimbursement, all of which must be understood and mastered by billing departments.
They say federal regulators are increasingly scrutinizing the billing practices of large physician groups even as billing managers are struggling to decide on which of the many technological advances in billing systems they can afford.
Williams says doctors often ask him how many people they need to do billing properly and how much they should be paid. Physicians also want to know the kinds of overall costs they should expect.
For two years, the duo have done a survey of physician practice billing managers to elicit answers to those questions and provide some hard data.
"We hope those attending go away with a feel for the average costs and staffing levels of billing components of physician offices," Williams explains.
He says at past MGMA sessions he and Woodcock have focused on large academic physician practices of 300 or more doctors, but this year they will examine private practices of between 30 and 200 physicians.
"Billing has become so much more complex because of managed care that more providers are spending greater portions of revenues on billing," he says. "The survey is designed to let people know where they fit in."
Woodcock, a Duke University graduate who earned her MBA in healthcare administration at the Wharton School of Business at the University of Pennsylvania, says she and Williams found there were many studies relating to nursing staffing in physician offices.
"But few looked at billing processes there," she says, pointing out that an average of 4% of surgeons' revenue are spent on billing, while emergency physicians may spent up to 12% of their revenue on processing claims.
"That's a big chunk of your money. There was nowhere for billing managers to turn to get an idea of how they compare to other offices. The information just doesn't exist."