MEDICAL BILLING BLOG

Key Elements of a Good Medical Billing Bonus System

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I have had several questions submitted about how to design a good medical billing bonus system. To help folks that are considering implementing such a system I thought I would share a few key elements of any good billing bonus system. An effective medical billing bonus system is...

• Significant enough that people care about whether they achieve the bonus (a good bonus system will increase the base pay by between 15 and 20% for outstanding performers);
• Paid monthly - less frequently than that and people tend to discount the value;
• Differentiates between up front processes (getting claims out clean) and back end follow-up (dealing with claims that have denied);
• Based upon objective and not subjective measures;
• Outcome driven and not effort driven (i.e., based upon how many claims resolved within 60 days not how quickly claims are submitted);
• OIG compliant (primarily gives no incentive for up coding);
• Not easily gamed through tactics such as writing off hard to collect claims; and
• Balances the individual and the team. Success in medical billing is a team effort that includes the front desk, the data entry people, the insurance follow-up people and the patient follow-up people. Not everyone on the team, however, typically contributes equally. The bonus should reward the team but reward the stars a bit more than the rest.

A well designed bonus system for a medical billing department can be a challenge to design and implement, but it can pay huge dividends in terms of employee motivation and aligning their incentives with those of the practice.

Copyright 2009 by Carl Mays II, President, ClaimCare Inc