How do I find benchmarking for staffing ratios?

Q: I manage the billing department of an infusion company that does both infusion and durable medical equipment billing. Are there any benchmarks for staffing ratios, such as how many staff I should have for a specific volume of accounts? Our DSO hovers around 115 and our staff tell me they’re “overworked,” but how do I know for sure if they are or aren’t?

A: Benchmarks for staffing ratios are best internally developed based on a combination of factors. The basic approach we use with our clients is to first identify and document the individual tasks associated with the billing function. If billing also includes follow-up and denial resolution, then those areas should also be listed. For each detail, the manager then needs to develop two measurements: the volume of work and the time needed to perform one unit of the work. Thereafter, it is simple math to calculate the amount of time needed to complete the specific volume of work. Next, determine the productive vs. non-productive hours paid, and use that information to determine the total number of FTE’s required.

The challenge is to obtain accurate time values. For example, if insurance verification is performed electronically, the time unit is typically very short-30 seconds or less per transaction. However, if verification is by website or telephone, then longer times will be the norm. It may be necessary to divide the volume of work for some tasks into electronic vs. manual processing, and calculate the different times accordingly.

Because each organization includes different tasks within a particular job category, external benchmarks can be misleading. We recommend the time and volume approach because it is geared to your specific environment and organization of work.

This question was answered by Sandy Wolkskill, FHFMA, president of Wolfskill & Associates in Chardon, OH.