Probably THE most overlooked division of your practice is the billing and coding department. Whether you outsource your billing, or do it in house, it is vitally important that they have an open line of communication with you. This will ensure that you are working in tandem to make sure that every dollar that you’re owed from the payer is received by you to enhance your bottom line.
This article is a continuation of the last blog that will give ideas on how to increase your bottom line without having to raise your overhead.
- All claims should be submitted within 24 hours of services rendered.
A 24-hour turn around for claims should be the standard in any coding/billing function that you have. This allows for the quickest payment of services rendered and allows for any denied claims to be dealt with in a timely manner. Denied claims handled after this time may be less accurate and definitely subject to a longer payment period.
- Be aware of your Accounts Receivable (AR) and make sure that it is being aggressively followed up on.
An AR report is imperative to see AT LEAST once a month because this allows stakeholders to see that all claims have been sent and that they have been scrubbed through a clearinghouse. If they have been ok’d by the clearinghouse, the likelihood that the charges will go unpaid will be greatly reduced. This also means that the patients’ balances can be resolved in a timelier manner, and be reconciled before their next appointment.
- Use modifiers, especially ICD-10 modifiers, properly
Modifiers. OOOH the Modifiers. They can truly be your best friend (when done correctly) or your worst enemy (if done incorrectly too many times, can lead to audits). The good news about ICD-10’s is that modifiers will be less used because of the more exact that the codes have become. If you still have to use a modifier, one must make sure that the procedure’s codes were actually performed and that there is stringent documentation to support the modifier. If there is ever doubt, error on the side of caution. Ask the provider if the additional services were performed and that what is entered is legit. If they are overlooked or used improperly, you could be audited for fraudulent claims.
- Update Medicare at least quarterly
Medicare rates are updated every three months. What does this mean to your practice? You should make sure that all of your data is updated quarterly so that you are receiving all payments due to you at the highest rate. When Medicare reimbursement changes, it is possible that other insurance reimbursement rates change so it would behoove a practice to check medical payback rates at least this often.
- Reduce the number of no-shows.
As stated in the last blog and countless times elsewhere, time is money. It is vitally important to make sure that the scheduled patients show up, well, on schedule. This day in age there are a plethora of free or inexpensive or free ways to remind people via email, text or voicemail that they have an appointment nearing. If you aren’t familiar with this technology just Google it and many ways, including the help of a Google company, will show up. Pick one you feel you are comfortable with and remind your patients about an upcoming appointment. Because remember, No Show=No Pay.
- Have educated billers.
Sounds simple enough, right? The truth is that the times, they are a changing. With the advent of the ICD-10’s, codes will go from 3-5 numerical codes with possible modifiers to a, truthfully, more accurate 5-7 ALPHANUMERIC code with a 3-5 digit modifier. What does this mean? On one hand it could mean more exact matches for each service rendered, in turn meaning a more accurate repayment, but, if the billers you entrust with your cash flow are not educated this may mean more time dealing with denied claims, more time with patient payments ultimately meaning more time with less revenue.
The billers and coders at Midwest Medical Billing, LLC. are certified in the upcoming ICD-10 transitions and would love to assist you in showing you how an experienced biller or coder can help you earn more revenue. Contact us today to see how we can help!
Quote of the day:
“Put your heart, mind and soul into even your smallest acts. This is the secret to success.”-Swami Sivananda