By Jane Ehrhardt

Administrators now spend more time handling recruitment, retention, and staffing shortages than before the pandemic. “These shortages and continuous training of new staff members place a strain and backlog in the revenue cycle,” says Tammie Lunceford, CMPE, CPC, a senior healthcare consultant with Warren Averett.

The shortage of qualified candidates coincides with the end of the pandemic slump, exacerbating the problem. Patients are avidly seeking to schedule delayed visits and procedures, especially in surgical specialties like orthopedics, where knee and hip repairs are at record levels.

As a result, Lunceford is seeing both large practices and new startups facing reimbursement situations that point back to staffing. “The root of their problem is they can’t hire enough staff or they have a large turnover of those who had the knowledge,” she says.

Once staff comes on board, practices can fail to utilize or keep them by stinting on training, leaving new hires to learn on their own. “Make sure that each position has a checklist of vital functions to create consistency and clarity,” Lunceford says. “That includes the front desk personnel because they are starting the claim when the patient arrives. And tell new hires their role in the reimbursement cycle and how you’re relying on them. When employees understand their relevance, it creates a buy-in for them in the success of the business.”

For the first 90 days, assign new staff members a mentor to help meet their checklist functions and guide them through practice nuances. If the new hire hasn’t become proficient in their checklist after 90 days, let them go.

To maintain the most efficient usage of the technology, assign any training to a super-user of that software or device in each department, such as front desk, clinical, billing, and scheduling. These are the personnel with extensive training who not only know how to use the tech, but also how it applies to that department, keeping the workflow consistent and avoiding the legacy of hand-me-down errors.

Keeping staff long enough to become super-users requires an ongoing training investment many clinics mistakenly bypass. The alternative is not only constant turnover, which costs more money, time, and resources to resolve, but a less adept staff. Longevity of staff allows time to grow their expertise, which leads to improved workflows for a more successful revenue cycle.

When there is not an ongoing training program, staff often get blamed for inefficiencies when the problem actually lies with underusing the technology. “Administrators may have no problem with purchasing technology, but then they don’t ensure it’s working optimally for them,” Lunceford says, about practices that get mired in staff or administrative turnover and lose focus. They move away from tapping into all the resources it offers.

For instance, a check-in kiosk system that could be better integrated with the practice management or EMR system could relieve staff of performing multiple steps in the workflow. “You don’t want to pay for technology and not get good results with your staff or your patients,” Lunceford says. “Training, such as attending annual user conferences, leads to a higher investment in the business by staff and likely money-saving adjustments.

“As updates roll out, make sure managers are updated on software, as well. Management must learn the technology in order to hold staff accountable and troubleshoot problem areas. When you grow your staff in their knowledge, you are investing in the person, and they know it. They stay engaged that way and can help you work out problems.”

The managers of each department dealing with reimbursements, including front desk and clinical, need to meet to review month-end reports to assure any technology issues, staffing problems, and trends are resolved moving forward. “Look at the key performance indicators and brainstorm on how they are different from last year at this time, as well as last month,” Lunceford says, “because the doctors are going to have questions. Know what answers you are going to give. Make sure you have a plan.”

Personnel are becoming more expensive, not just to find, but to keep. Recent salary survey results for Alabama show a 10 percent increase in pay on average over the last two years for front desk personnel, billers, and coders. “It only makes sense,” Lunceford says, “to keep staff trained, efficient, and knowledgeable enough to work the clients and get the money produced.”