Follow 3 Tips to Improve Your A/R Process and Boost Your Collections

Avoid the ‘code it, bill it, and forget it’ mentality — don’t be afraid to follow up on your claims.

The economic downturn coupled with looming healthcare changes means that your practice — and all others — are under more pressure than ever to collect every penny you deserve.  You can refine your accounts receivable (A/R) process quickly and easily to bring in the money without a lot of extra effort.

A/R defined: “Accounts receivable (A/R) is the money that is owed to the practice,” explains Elin Baklid-Kunz, MBA, CPC, CCS, a director of physician services in Daytona, Fla., during The Coding Institute’s audioconference “Top A/R Tactics: Fight Back Against Lower Payments and Increased Government Scrutiny.”

Follow these three best practices to set your practice on an improved A/R track and avoid thousands in lost reimbursement.

1. Monitor Each Claim You Send Out

The first step in perfecting your A/R process is to make sure someone in your practice is paying attention to what happens to every claim you submit. Ask questions such as: “did the insurance company even receive the claim?” and “Did the patient pay her copay portion of the bill?”  “There are companies out there I call ‘code it, bill it, and forget it companies,’” says coding, billing, and practice management consultant Steven M. Verno, CMBS, CMSCS, CEMCS, CPM-MCS, in The Coding Institute’s audio conference “Reveal and Recover Hidden Money You Didn’t Know You Missed.”

“They code the claim, they bill the claim, and then they forget about it. They leave it out there and don’t do anything to bring the money in. They don’t follow up on the claim.”  Following up on your submitted claims early in the game can save you time. First ensure that once your practice submits a claim that it is...

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Bone Scans: 3 Tips Help You Code Osteoporosis Screening Successfully

Your practice is going to have more patients coming in for bone density screenings, thanks to new recommendations from the U.S. Preventive Services Task Force (USPSTF) that might lower the age at which family physicians could begin screening some women for osteoporosis. Act now to ensure you’re assigning the correct diagnosis codes and verifying medical necessity.

1. Know Osteoporosis, Osteopenia Differences

Many people think of osteoporosis when they hear the term “bone density screening.” Osteoporosis — which literally means “porous bone” — is a disease characterized by low bone mass and structural deterioration of bone tissue. The changes lead to bone fragility and an increased risk of hip, spine, and wrist fractures. The condition is essentially a bone disease caused by dropping estrogen levels in postmenopausal women.

When your physician diagnoses osteoporosis, you’ll select from code family 733.0x (Osteoporosis). Choose the diagnosis based on the patient’s specific type of osteoporosis (such as postmenopausal, idiopathic, etc.). A less-thought-of diagnosis related to bone density screenings is osteopenia (733.90, Disorder of bone and cartilage, unspecified). Patients with osteopenia have lower than normal bone density.

Although osteopenia can be a risk factor or precursor for osteoporosis, not every patient with osteopenia develops osteoporosis.

Screening: Your physician will most likely order a dual-energy x-ray absorptiometry (DXA), which measures bone density, to diagnose the condition. DXA is the gold standard for measuring bone density, coder Donna Richmond with CodeRyte taught in The Coding Institute’s audioconference “Surefire Bone Density Screening Strategies.” Your code choices include:

  • 77080 — Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (e.g., hips, pelvis, spine)
  • 77081 — … appendicular skeleton (peripheral) (e.g., radius, wrist, heel)
  • 77082 — … vertebral fracture assessment.

2. Check for Documented Necessity

Medicare guidelines dictate that your documentation must include an...

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