Any organization that bills to Medicaid is familiar with the frustration of delayed billing and payments. These frustrations can become crises if you miss a payer’s fiscal year end billing deadline. These are billing calendar deadlines set by individual payers occurring shortly after the beginning of the new fiscal year. Some payers will make an effort to notify your organization as their billing deadline approaches – others may not. Some payers may set their deadlines 60 days after the start of the new fiscal year – others may set it at one week. Because of the variations in these deadlines, providers are often unaware that such deadlines even exist.
While there are variations in deadlines among payers, there is a common element – they all matter to the health of your company. Here is why you must mind these dates:
Medicaid funds have a shelf life
After a certain point, the Medicaid funds for a given payer for the previous fiscal year are no longer available to that payer. There is no avenue for appeal in this scenario, as you will be attempting to recover money that no longer exists. The result – sizeable write offs.
Your billing backlog could be at risk
Typically, weekly medical billing does not catch all services provided. Exceptions, billing corrections, re-bills, and backlogs add up quickly. Missing a fiscal year end billing deadline could render these services permanently unbillable.
Your provider/payer relationship could suffer
A payor with a positive option of your organization is far more likely to cooperate with you when it comes to billing exceptions, errors, and extraordinary billing concerns. Missing a fiscal year end billing deadline creates a lot of extra work for payors (many of which are under resourced as it is), which can jeopardize your good standing with them.
Last minute billing negatively affects regularized billing
Devoting billing resources to a last minute scramble to bill/rebill payers in the face of a rapidly approaching deadline steals resources from normal billing. This causes for your billing backlog to grow, resulting in further resources needed to bill through said backlog, which ALSO steals resources from normal billing, creating a vicious circle that will weaken your recurring revenue stream.
Most billing errors are fixable, but missing a fiscal year-end deadline generally is not. Your billers can avoid this by actively acquiring fiscal year-end billing deadline dates from your payers, using those dates to create individual billing strategies to assure that all fiscal year end billing deadlines are met, and normal billing is not interrupted. Don’t allow your organization to be caught off guard – always keep fiscal year end billing deadlines in mind.
Joseph DesOrmeaux leads a medical billing team for a multistate behavioral therapy provider based in Novi, MI. He specializes in generating billing strategies for new payers and allocating professional resources for regularized billing of payer networks. He is also a gummi bear connoisseur, and will discuss the subject at length given the opportunity.