Infographic: Are You Gambling with Your Patient Collections?

May 31st, 2012 by Joann Doan

Think it doesn’t matter when you try to collect from your patients? Think again—statistics show that you have less than a 40% chance of collecting from patients if you wait until after treatment. Compare that with the fact that if you go to a roulette wheel in Las Vegas and just bet on red, you have a 47% chance of winning!

That’s not the only thing that’s changed about patient collections; see our infographic  below to see how you fare with collecting copays, deductibles and the source of most bad debt.

Are you gambling with your patient collections? This infographic explains the odds of collecting

For information on improving your odds with patient collections, review these resources:

And for more methods to improve your bottom line, be sure to register for our complimentary webinar, Stop Denials in Their Tracks: Get Paid the First Time by Health Care Insurers, on June 19 – register now.

Read More | 13 Comments | Filed in General, Training

Find Out How to Make Your Medical Billing Easy in a Kareo Demo Webinar

May 30th, 2012 by Joann Doan

Learn how to make your medical billing easy in this free Kareo demo webinarIf you couldn’t make our demo webinar today but would still like to see how Kareo’s easy to use medical billing solution can help streamline your office, you are invited to join us for our next free demo webinars on June 7 or June 26 to learn how Kareo medical billing software will make medical billing easy for you as you improve your profitability.

You’ll hear how you can:

Save money on your medical billing by paying one affordable monthly fee for software and clearinghouse
Keep things from falling through the cracks – quickly and easily see what claims need to be followed up on, which insurance companies haven’t responded and more
Use easy to customize reports to see which procedures are most profitable, which providers are most productive, and much more
Implement an integrated EHR/medical billing system with Kareo and one of our 8 EHR partners, providing you with freedom of choice in which EHR you use
● Improve your profitability with better patient collections and reduced no-shows using Kareo’s patient payment services and phone appointment reminder service

Starting at just $69 per provider per month, Kareo is the easy, affordable medical billing option that is trusted by thousands of doctors.

We’ll show you why.

During this one-hour webinar, you’ll see in detail how Kareo’s easy to use features help you make your billing more productive. You’ll also have the opportunity to ask questions and learn how Kareo suits your specific needs. Please note that this webinar is designed for those who are not currently using Kareo but are interested in learning more about our easy, affordable application.

Title: Kareo Demo Webinar: How to Streamline Your Medical Billing
Date: Thursday, June 7, 2012 or Tuesday, June 26, 2012
Time: 10:00 AM – 11:00 AM PDT (1:00 PM – 2:00 PM EDT)

After registering, you will receive a confirmation email containing information about joining the webinar.
Space is limited.

Reserve your webinar seat now for the dates indicated below:

June 7, 2012                                  June 26, 2012
1:00 PM EDT/10:00 AM PDT            1:00 PM EDT/10:00 AM PDT

Register now to learn how to make your medical billing easy in this complimentary Kareo demo webinar  Register now to learn how to make your medical billing easy in this complimentary Kareo demo webinar

Read More | No Comments | Filed in Company, Events, Features

Medicare Now Accepts Physician Enrollment Applications 60 Days in Advance

May 25th, 2012 by Joann Doan

CMS announced that practices now have 60 days for physician enrollment

Practices now have a longer time frame to submit their physician enrollment applications to the Centers for Medicare and Medicaid Services (CMS). Until recently providers were only permitted to send their application to their Medicare contractor 30 days in advance of the “effective date” which is the later of:

1) The date a physician filed an application that is ultimately approved by Medicare; or

2) The date a physician began furnishing services at a new practice location.

Under new guidelines CMS has extended this date to 60 days, with some exceptions. The change was effective May 14. Read a recent “Medicare Learning Network Matters” article outlining this change.

For more information on enrollment, visit the Kareo Help Center.

Read More | No Comments | Filed in General

Vote for the June Medical Billing Tip of the Month!

May 23rd, 2012 by Joann Doan

Vote for the June Medical Billing Tip of the MonthHere’s your chance: You decide the winner for our June Medical Billing Tip of the Month contest! Listed below are the three top tips submitted this month (out of the many great ideas we received!). Just read them over and then post on our Facebook page which number is your choice for Medical Billing Tip of the Month. You can also post your choice in the Comments box here on our blog. Either way, be sure to vote before the deadline of Wednesday, May 30! The winner will receive a $250 American Express Gift Card and the acclaim of their peers. Here are the candidates: 

1. Check for Symptoms to Support the Diagnosis

When your providers send the Superbills to be entered, sometimes the level of service isn’t justified by the diagnosis that is chosen. When they spend the alotted time with the patient and you are trying to find justification for the level of service, make sure to check the documentation for SYMPTOMS.

Every patient comes to the office with one or more symptoms or issues that need attention, for example:

If the patient is coming in for anxiety or depression, look for symptoms as well. There may be insomnia, weight loss, decreased appetite, lethargy, mood changes, sleepiness, exhaustion, etc.

In other words, if you spend the time, as you would with a patient with depression, use those symptoms. Don’t forget to make sure that these codes or diagnosis are documented (don’t guess or make them up!).

Also, don’t give a patient a definitive diagnosis without justification. For example:

Diabetes Mellitus: Don’t flag a patient with DM until it is definitive. Code those symptoms documented, such as tiredness, increased urination, weight loss or gain, altered mental status, increased thirst.


2. Utilize the Various “Tabs” in the “Find Patient/Edit Patient” Section of Kareo to Increase Efficiency and Revenue

To access your patient profile, Kareo has several areas for your convenience and preference. You will see it under short cuts, tool bar, the F7 speed key, the choice is yours.  Once you find your patient, it will take you directly to “Edit Patient.”

Under the “Blue Bar” you will see several tabs:

General | Cases | Alerts | Account | Documents | Tasks | Log |

1.  The “General” tab gives you an overview of that patient’s account.  From here you can edit any information that is outlined OR you can add any information that is missing such as a phone number for home, work or mobile number.  The more information that we have, the more efficient our billing and collection efforts are.

2.  The “Cases” tab gives you all the cases that are associated with this patient; you have the option to “Add a Case.”  Our clinic assigns everybody a “Self Pay” (no insurance linked to it) to use for charges that will not be billed to insurance such as:  No show & cancellation charges, over the counter purchase of items that is not covered by insurance etc.  This eliminates a rejected claim should items without a CPT code be billed in error.

3.  The “Alerts” tab is great to use for any pertinent information specific to that patient, and will notify you or another person of that “Alert” once you access the patient, depending on the options you choose.  When the “Case” tab is accessed you can type the “Alert” specific to that patient and then choose some or all of the 6 options that you would like this to appear.  This has helped us tremendously by keeping the lines of communications open, obtaining information from the patient if needed when they are here for the appointment, as well as insurance specific information needed to eliminate rejected claims.

4.  The “Documents” tab allows you to store documents you have scanned in or attached that are specific to this patient’s profile.  This is great for ID cards, intake forms, prescriptions, authorizations…The sky is the limit!

5.  The “Tasks” tab is a favorite. Some of the ways we use this are to follow up on insurance for reprocessed claims or as a follow up to patients on prescriptions.  Anything that you would put on your desk calendar or on a yellow legal pad could go in this section. You can assign it to any person who is set-up in Kareo, issue a due date and identify if the task is related to a patient, encounter or payment.  These tasks can also be prioritized as you will see within the Task section. On the Kareo home screen you will see on the “To Do List” the tasks will appear as part of your daily activities.  There is a hyper link so that you can easily access your tasks and complete them. There is a “Tasks” option at the very top of Kareo on the tool bar and can easily be accessed. 

6.  The “Log” tab is fairly new.  This tab keeps a log of any current actions that occurred on this patient’s record.  The log will show the information changed by: Time, User and Description.  This will help the internal staff track what and when the changes have been made to the patient’s profile.

All of these tabs are great tools to utilize as an aid to help increase revenue by reducing rejected and denied claims as well as a form of communication within the staff.  


3. Organize Patient Accounts for Collections in Kareo

I have created a way to systematically move patient accounts into buckets for our patient collections. I created collection categories and named them with numbers so that the collectors can see the list of collection buckets in order as to how the collection process works. From there I customized each category for statement messages, alerts, and if a statement should be sent or not.  Then when we run our collection report, all the accounts are in the right bucket.  Form this report we call or send letters, then tag the account the next step for next month.

For example:

1 Current

2 Automated payment reminder – this is an auto call using a 3rd party vendor

3 Delinquency letter

And so on.  The method you use for working your patient balances would be how you create your collection categories.  See example below:

The candidates for the June Medical Billing Tip of the Month include this tip for a method to organize patient accounts for collections in Kareo

Which tip is your top choice? Vote now on our Facebook page or in the Comments box on this blog. You have until Wednesday, May 30, to vote! We’ll announce the winner in our June newsletter.

Read More | 1 Comment | Filed in Events, Features

Claim Scrubbing – Clean Your Claims Before Submission to Improve Denial Rates

May 22nd, 2012 by Joann Doan

Medical billing is a complex, ever-changing industry, and the amount of information that a typical billing claim contains is almost staggering. Between patient information, insurer information, provider information and physician information, there’s tremendous room for error.

Add to that the complexity of diagnosis and procedure coding, and getting paid becomes an even greater challenge. With over 13,000 ICD-9 diagnosis codes, over 3,000 ICD-9 procedure codes, continuously updated CPT, HCPCS Level I and HCPCS Level II procedure codes and all of the possible (and impossible) combinations between them, it’s a wonder that the system operates as efficiently as it does.

And of course, for the claim to be approved, each piece of information simply must be accurate.

Creative coding

Julie Bajer, operations coding manager at Seattle-based Group Health Cooperative, recently asked six different coders on her team the same coding question. She wasn’t surprised when she got six different answers, each of which was correct. “Coding is much more of an art than it is a science,” says Bajer. “So [coding professionals] definitely have a lot of room for interpretation.”

Interpretation is fine, as long as the interpretation is correct—and reimbursed. Rejected claims aren’t open to interpretation, and require extra research—and staff time—before resubmission. So, any rejections that can be avoided will improve the practice’s bottom line.

Kareo makes it easier

Kareo has recently added a new claim scrubbing feature to its software that brings this complexity back down to a manageable size. This new feature will perform pre-submission audits on all currently supported medical billing claim formats, including CMS-1500, 837P and 837i.

Claim scrubbing is a process of validating the combination of data on a health insurance claim. This validation covers two key areas, including:

  • The patient/insured/provider/insurer data and
  • The actual services performed by the practice and submitted to the payer as documented in diagnosis, procedure, modification and revenue codes.

The data submitted on the claims is validated against Medicare, Medicaid, National Correct Coding Initiative Edits (CCI Edits) and other standard coding rules.

Two scrubbers in one—free

Many billing software products utilize an unmodified version of the CCI Edits to check claims, but only check for missing components and verify that the data is being submitted in the correct format. They don’t audit for coding validity of diagnosis, procedure, procedure modifier and revenue codes. Kareo’s new claim scrubber feature does all of the above, making it one of the best in the industry, in our opinion.

Claim scrubbing can reduce and eliminate simple data errors that would result in denials and rework, but it also watches for more complex issues such as mutual exclusiveness, comprehensive component and medically unlikely procedures. Specialty practices that rely heavily on diagnostics can efficiently test their documentation of medical necessity. Users get alerts for every charge transaction that is contrary to current Medicare coverage rules and have the opportunity to correct them before submission.

Considering the pace of change in the industry, it’s simply unrealistic for this process to be handled manually. By using Kareo medical billing software with its claim scrubbing feature, you can reduce claim denials, uncover missing charges, reduce submission costs and accelerate your reimbursement cycle. Studies have shown that 15%-20% of cases marked for review are eventually recoded for higher reimbursements! With Kareo and our new claim scrubber, you can get it right – and even get paid more – the first time.

And best of all, this new claim scrubbing feature is included in all plans, at no additional cost. That’s right—it’s free. It doesn’t get much better than that!

You can find additional information on reducing and avoiding claim rejections in our Getting Paid blog in posts including:

Read More | No Comments | Filed in Features, Releases

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