Your billing process is spot-on and your billing system runs like a ’66 Shelby 427 Cobra—but somehow your payment cycle is stuck in an Abbott and Costello skit with Who on first, What on second, and I Don’t Know on third. So, what’s causing such a major-league breakdown in your revenue stream? The human factor. Before your season’s over for good, it’s time to give a darn about your billing team. Here’s what to watch for when evaluating your staff:

The Stats

Your team is only as strong as its weakest link, so you need to make sure that all of your billers have the skills necessary to bat a thousand. At their core, billers should be self-starters, problem-solvers, detail fanatics, and good communicators. Additionally, your billers should be able to:

  • Compute charges
  • Accurately enter patient data
  • Follow proper procedure
  • Maintain insurance claim support documentation
  • Understand basic anatomy and medical terminology
  • Receive and receipt cash items
  • Understand diagnostic and insurance codes

If your team is full of top talent, great! If not, you may need to make some hard decisions. No one wants to get a red tag in his or her locker, but you have to do what’s best for your team—and your bottom line. There’s no real cut day in billing, but if you decide to make a roster change, do so sooner rather than later.

A word to the wise: Don’t forget about your front office staff, either, because they have a pretty big impact on the productivity of your billing team. Check out this blog post for more information on what to look for in your front office staff.  

Size Matters

That’s right—I said it. The size of your staff may be just as important as the people who make up the team. To determine whether you’re fully equipped, you’ll first need to pinpoint a few figures that vary based on practice size—like the number of full-time equivalent providers, the cost per visit, and the cost of unplanned turnover. Then, compare your figures against current available benchmarks. You can find more information on these ratios and get help with making the calculations here and here.  

Designated Hitter

You’ve made sure that your staff is the right size and that everyone on your billing team has the general skills necessary to perform in that position. Now, you need to consider whether each biller is in the correct role for his or her abilities, strengths, and weaknesses. This also is your chance to evaluate the duties required of each role and make any necessary changes to improve efficiency and meet your clinic’s specific needs. Depending on the size of your practice, you may be able to divvy up responsibilities based on payer, patient name, collection amounts, tasks, or experience. Once you have each person in the role best suited to him or her, set and clearly communicate your expectations for each position.   

Spring Training

There’s a reason baseball teams take a month or so every year to get back into the swing of things. Your billers may be World Series champs, but even the best players can’t hit it out of the park without regular training. Don’t let a lack of continuing education keep some members of your staff on the bench (or in the minor leagues). Make sure every member of your billing team is ready to play—today—by taking some time to evaluate your current training program for breadth and depth of content. If you don’t have one, create one—now. Training not only helps your staff stay up-to-date on technical and federal regulatory changes, but also gives you the opportunity to re-evaluate your employees at regular intervals.


Doing a quick once-over of your billing team is a great idea, but you’re not trying to get to the All-Star Game or the postseason; you’re trying to keep your business in the black—permanently. Evaluating your billing team isn’t something you only do once. If you don’t have a system in place to routinely analyze productivity, no one on your staff—including you—will know how your team performs individually or as a whole (which is probably why you’re reading this blog post). To help you better evaluate your team on a consistent basis, set a productivity benchmark for each biller, and then create personal metrics and develop goals based on those metrics. Don’t forget about the Gold Glove and Silver Slugger awards: When your billers meet their goals, reward them for jobs well done. Pretty soon, your team will be catching all those missed payments and hitting invoices out of the park.