A newly issued federal regulation, if allowed to stand, would limit women’s access to care and force doctors to withhold information about all of their health care options. The AMA says…
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...
2011 adds a new modifier to your coding arsenal and updates the descriptors for several others you might often use. Get ready for modifier GU (Waiver of liability statement issued as required by payer policy, routine notice). You might have times when ...
If the doctor does not circle a diagnosis, it may be up to you to find one.
Don’t let an incomplete superbill damage your chances of submitting an accurate claim. If the doctor in your office fails to indicate the ICD-9 code for the condition that he treated, you should read through his documentation to find which diagnoses you should report.
Open the Notes When You Have to — and Even When You Don’t
Suppose your physician hands you a superbill with the procedures circled and the diagnosis left blank.
You could ask the physician which diagnosis to report, or you could examine the documentation yourself. If your office has a policy that includes “coding by abstraction” by certified/qualified coders, then submitting charges based on what is supported (documented) in the note is appropriate, says Barbara J. Cobuzzi, MBA, CPC, CPCH,CPC-P, CENTC, CHCC, with CRN Healthcare Solutions in Tinton Falls, N.J. The physician should be signing off on these charges as part of your internal policy.
Some practices choose to review the documentation and compare it against any diagnoses recorded on the superbill, even when they aren’t required to. This ensures that the documentation matches the code selection every time.
When in Doubt, Confirm With the Physician
If you are new at coding diagnoses from the physician’s notes, you should doublecheck your code selections with the practitioners before submitting your claims.
“Until a coder feels comfortable with the ICD-9 books and the codes used more often in their office, it’s a good idea to run the choices by a clinician,” says Suzan Berman, CPC, CEMC, CEDC, senior manager of coding and compliance with the Physician Services Division of UPMC in Pittsburgh. “You never want to give a patient a disease or symptom they don’t have ” or one more...
If your practice does lab panels, sleep studies, hospice visits and more, take heed. The HHS Office of Inspector General has published its 2010 Work Plan, which should give us all a heads up on what the watchdog agency will be auditing and evaluating this year. Why you should care: The 115-page document is like a map [...] Related articles: