Five Steps to Medical Billing Lockbox Selection

Lockbox helps medical practices streamline HIPAA-compliant mail processing and same-day check deposits. Electronic access to scanned documents, including EOBs, simplifies key office and billing processes and achieves multiple benefits:

• Reliability Better revenue cycle reliability via elimination of dependency on staff or on billing service for handling checks
• Transparency Lockbox allows bi-directional verification of check deposit between the bank and billing service. Doctor can personally verify deposit 24 x7 via secure Internet connection. No lost checks.
• Billing Efficiency Faster and better controlled submission of secondary claims
• Patient Service Efficiency Simpler and faster resolution of patient account inquiries and disputes
• Added Interest Revenue Automated or semi-automated posting of insurance and patient payments. Check deposit upon arrival. Automated investment of deposit in a Money Market account earning interest (Automatic Sweep). The doctor's money is never idle.

Operation

1. Practice mail arrives directly to the lockbox service
2. Lockbox service
   1. Opens all mail and archives it in a document management system including scanning and indexing for future retrieval,
   2. Makes images available to practice or Billing Service via a secure, encrypted Web site;
   3. Deposits all checks received that day
3. Practice administrative staff has direct access to web-driven interfaces for mail and check queries and reports

Implementation

Lockbox service is typically offered by two kinds of providers:

• Large-scale Vericle-like billing service vendor as part of service
• Specialized financial institution, e.g., bank

Lockbox Selection

1. HIPAA Compliance - Can the service guarantee access only on the "need to know basis" and only to qualified staff? Are all required privacy and security measures in place? Is there a solid disaster recovery capability and process?
2. Quality Assurance Process - What measures are taken to ensure timely error identification, correction, and tracking? Is there sufficient QA process transparency to allow the practice owner complete control of mail and checks?
3. Intuitive User Interface - How many steps are required to find a letter, EOB, or a check? What are mail and check indexing parameters?
4. Batch Interfaces - Is there a convenient way to download all or partial content of the document management system for upload in other systems, such as a billing system, or in alternative lockbox provider facility?
5. Timeframes - How long does it take to open mail, scan it into a document management system, and deposit a check? What is the time horizon for archived image storage? What is the time period for storage of original paper before shredding?

Complexities

Lockbox

• Must be fully implemented - a partial implementation only increases management complexity.
• Adds headache with payers - all payers need to change mailing address, adding error likelihood during transition period.