Learn How to utilize Lean in Medical billing process. You can avoid waste in the process and improve your billing efficiency. http://leanmedicalbilling.com

1. Lean Introduction:
MUDA Traditional Japaneselanguage meansas“Waste”. Way to increase the profitabilityof any
organizationistoreduce the cost and increase the productionandsales.Leanisthe methodtoreduce
cost and therebyincrease inthe revenue.
In the complete Medical billingprocess,eachandeveryprocesshasitsownvalue. All the stepsthatlead
to achievingthatpurpose are whatwe consider“value”. All the stepsthatdonot supportthe purpose
of the processiswaste.
There are 3 typesof activities,2of whichproduce waste:
A. Stepsthat definitelycreate value.
Each processshouldhave more of A to increase the efficiencyandaddingvalue tothe process.
B. Stepsthat create no value,but are necessarygiventhe currentstate of the system.
C. Stepsthat create no value and can be eliminated.
B & C createswastes. Needtotake necessarystepstoavoidthese stepswhichwill In- turnincrease
lessercostand increase revenue inMedical billing.
Type of Waste
Defects
 PoorQuality workcomparedto SOP
 Cost of Quality,needtodeployQualityteamtomarkerror and Rework
 Workedclaimsare not resolvedandAccumulationinARbuckets
 CollectionfromARworkisreducingdue topoor work
 Speedof collectiongettingaffecteddue topoor Quality
 Denialsnotaddressedproperly.
OverProduction:
 Unnecessarybucketsaddressed(0-30)
 Notgivingenoughtime forthe payerto processthe Claim.
 Gettingmajor% of Claiminprocessstatus
 NotallowingPaymentpostingteamtopostthe PaperEOB
 AddingnotesforunwantedorGlobal scenarios
 Same type of manual workwithoutautomation
Waiting:
 Waitingforotherprocessresolution
 WaitingforCodingreview
 WaitingforPostingteam’sresolution
 WaitingforAppealsteamtodownloadmedical records andprepare appeal letter
 Waitingforwork file fromTeamleader.
 WaitingforActioncode and Statuscode

2.  WaitingforSoftware
NotUtilizingTalent:
 Work file isnotdesignedproperly
 Peretoanalysisnotprojected
 Single patientworkordergiventomultiple associates
 Notgivenbypayerwise
 NotallocatedbyDenial wise
 Notallocatedintelligently
 Poormanagement
Transportation
 Unnecessarymovementtointernal department –Coding,Paymentpostingandsupervisors
 ExcessstepsinSOP.
 AdjustmentsnottakeninDenial postingitself
 AR doingPostingteamwork(Adjustments)
Inventory excess
 Working on recently filed Claims
 Working on recently worked Claims
 Working on Exception raised/Provider assistance claims without any response
 Addressing before payer processing completed
Motion waste
 Multiple tracking
 Associates updating production, appeals, coding, payment posting trackers daily (Which can
be easily done by Team leader by Report or from PMS itself
 Manual work instead of automation
Excess processing
 Multiple workorder
 Same workorder allottedtotwoor more
 Uncollectable work –auditedandreworkdone
 Qualityauditonadjustmentnottaken
 Qualitynotutilizedforbettercollection.