A reliable billing and collections process is essential for healthcare staffing agencies because hospitals and medical facilities have strict compliance rules, multi-step approval workflows, and long payment cycles. A clean, structured workflow helps your agency get paid on time, reduce DSO, and prevent avoidable disputes.
Below is a step-by-step guide to building a stable, efficient billing and collections system that keeps your cash flow predictable.
1. Collect Complete, Verified Documentation
Missing or incomplete documentation is the most common cause of delayed payments.
Required Documents
- Approved timesheets
- Overtime authorizations
- Unit or department coding
- Facility-specific billing forms
- Orientation or training hours
- Any compliance paperwork required by the facility
Best Practice: Use documentation checklists for every hospital or VMS/MSP account.
2. Standardize Timekeeping and Approvals
Timekeeping inconsistencies lead to disputes, which stop invoices from being approved.
What to Standardize
- How clinicians submit hours
- When hours must be submitted (within 24 hours)
- Required signatures (clinician and supervisor)
- How overtime and float hours are documented
Provide clinicians and recruiters with quick-reference guides for each facility’s timekeeping rules.
3. Create a 24-48 Hour Invoicing Workflow
Fast invoicing leads to faster payment.
Workflow Tips
- Run payroll the same day every week
- Create invoices immediately after payroll
- Submit invoices within 24–48 hours
- Automate rate calculations and coding where possible
Missing weekly billing cycles can add an extra 7–14 days to payment times.
4. Master Facility-Specific and Portal Billing Requirements
Hospitals increasingly require billing through portals like:
- ShiftWise
- Medefis
- RightSourcing
- Aya Connect
- Epic or Cerner billing modules
Create Portal SOPs
Document:
- Step-by-step submission instructions
- Required fields
- Required attachments
- Approval workflow within the portal
Portal errors often prevent your invoice from being accepted at all.
5. Use a Structured A/R Follow-Up Cadence
Follow-up cadence example:
- Day 15: Confirm receipt
- Day 30: Request approval status
- Day 35: Phone call + resend documents
- Day 45: Escalate to AP supervisor
- Day 60+: Executive escalation
Consistent follow-up prevents invoices from stagnating.
6. Implement Internal Quality Assurance Before Submitting
Quality checks reduce disputes by verifying:
- Correct bill rates
- Timesheet accuracy
- Complete documentation
- Correct cost center or department codes
- Portal formatting requirements
Always run a QA check before sending the invoice.
7. Track Aging Reports Weekly and Flag Risks
Weekly aging reviews catch issues early.
Aging Categories
- 0–30 days: Normal billing
- 31–45 days: Monitor closely
- 46–60 days: Follow-up escalation
- 60+ days: High risk
Flag facilities with chronic slow-payment patterns.
8. Strengthen Collections With Clear Escalation Paths
Collections should be systematic:
- Ask AP for payment timelines
- Request reconciliation calls for disputed invoices
- Escalate to higher management when needed
- Review contract terms if delays persist
- Pause new placements for severely overdue clients
Proactive escalation protects your cash flow.
9. Use Funding Support to Stabilize Cash Flow
Because hospitals often pay in 45–75 days, many agencies rely on funding partners to:
- Cover payroll
- Stabilize cash flow
- Handle A/R management support
- Run credit checks on facilities
Funding accelerates cash flow during growth periods or slow facility payment cycles.
Conclusion
A reliable billing and collections process for healthcare staffing requires:
- Complete documentation
- Standardized timekeeping
- Fast invoicing
- Portal billing accuracy
- Structured A/R follow-up
- Weekly aging analysis
- Strong escalation paths
- Strategic funding support
When your billing is predictable, your cash flow becomes stable—and your agency can grow without disruption.
