Time to Vote for the September Medical Billing Tip of the Month!

August 30th, 2012 by Joann Doan

We need you to judge our monthly 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, September 5! The winner will receive a $250 American Express Gift Card and the acclaim of their peers. Here are the candidates:

1.     Use the Account Activity Report Effectively to Identify the Unpaid and Underpaid

Go to Reports – > Productivity & Analysis – > Account Activity report -> Change the date as “Year to Date”

Just click the refresh button to view the report for all the codes submitted from Jan 2012 to present date.

The first Medical Billing Tip of the Month candidate is "Use the Account Activity Report Effectively to Identify the Unpaid and Underpaid"


Here’s how to use this report effectively to know the status of a particular code for a specific payer:

  • Set the Account Activity Report for update as “Year to Date.”
  • Go to Customize and update the CPT in the Procedure column. You can list multiple CPT’s using a semicolon.
  • Reports get generated for these codes submitted to all the payers year to date.
  • Convert the report into Excel and identify the payers which paid low for these codes.
  • You can use this report to identify the status of the codes in a set. For example, Consult codes, New patient codes, X-ray codes, Surgery codes, MRI codes, PFT set of codes (Cardiology), Doppler U/S, Lexiscan nuclear stress test etc.
  • Identify the unpaid and underpaid codes by carrier by using this report.

You can use these reports effectively for specialty practices in which the provider performs surgeries. When the provider performs a specific surgery which was billed with high dollar amount, he will be curious to know the status of the high billed claim. By using this report, we can identify whether all the payers are paying accordingly to the fee schedule rate or not. The non-paying and underpaying carriers can be identified easily by using this report.


2.  Bill Miscellaneous Codes Separately

My billing tip is to bill any miscellaneous codes on a separate encounter.  That way the office visit or other services that have specific codes can go through effortlessly while the miscellaneous code gets stopped for review.  This method has reduced my claim processing by approximately half for claims that would have included a miscellaneous code.


3.    Control the Top 10 Internal & External Denials Using the Denial Summary Report

We are using the Denial summary report to control the internal and external denials in our providers’ practices

Go to Reports > Payments > Denial Summary > Change the date to “Year to date.”

By generating the report, you can view the claims denied with the denial code and the total amount. Just generate the report into an Excel spreadsheet and sort the denials in descending order by total amount. You can also drill down to the billed amount to review the CPT and the carrier for a particular denial code.  Then categorize whether the denial is internal or external. Here is the report for reference:

The third candidate for Medical Billing Tip of the Month is "Control the Top 10 Internal & External Denials Using the Denial Summary Report"

For example: Co-22 – Payment adjusted because this care may be covered by another payer per coordination of benefits.

Ex: C0-26 – Expenses incurred prior to coverage.

Ex: Co-27 – Expenses incurred after coverage terminated

Internal Denial: The above denial is related to eligibility and we need to categorize only the eligibility denial based on the Kareo plan. If we have the Kareo “Complete” plan, we should have checked the eligibility before submitting the claims. Then it falls in the Internal Denial category.

External Denial: If you don’t have the option to check eligibility within Kareo, then the denial falls in the External Denial category. We can stop these denials by changing to the Kareo “Complete” plan or by checking the providers’ websites and/or educating the front office to check eligibility.

Denials other than eligibility should be checked and sorted into Internal & External categories.

Using this denial summary, we need to categorize the denials as Internal & External denial by the top 20 denial codes. Based on the type of denial, we need to educate our team to reduce these denials. If most of the denials are related to Internal error, we need to provide guidance and education to the team to reduce such errors in the coming months.

For External denials, we need to co-ordinate with the coding team and provider office to stop the denials such as “denied as non-covered service,” “rendering provider is not eligible,” “Pt enrolled in Hospice.” etc. We need to educate the providers to document the medical records more specifically for the service rendered to avoid such denials.

Steps to be followed to reduce denial %:

  • Generate the Denial summary from year to date and convert into spreadsheet
  • Sort the denial by descending order by total billed amount
  • Categorize the External and Internal denials from the Top 20 denials
  • Identify the Root cause of the Denial
  • Create a good solution to reduce those denials one by one with the help of coding expert
  • Educate the team and provider office with the perfect solution for these denials
  • Next, you will see the denial percentage reducing drastically in the coming months

Denial Category Metric:

If a practice gets less than 5% of denials in the total monthly billed amount, then the practice is in the “Best” category. More than 5% denials should be monitored and need probe review to bring down the denials. The clean claim percentage can be increased by using the report effectively

Best Practice  -  Less than 5%

Average           -  Between 5 and 10%

Alarm Bells     -  Greater than 10%

Conclusion: Managing your denials = Improving your revenue cycle.

Which tip is your top choice? Vote now on our Facebook page or in the Comments box on this blog. You have until Wednesday, September 5, to vote! We’ll announce the winner in our September newsletter.

Read More | 141 Comments | Filed in Events, Features

August Release: New Kareo Dashboard Simplifies View of Accounts Receivable, Encounter Enhancements Streamline Multiple Format Claims, More

August 20th, 2012 by Joann Doan

We’re pleased to announce our latest release featuring three major enhancements including a brand new reporting dashboard to help manage your accounts receivable, a new way to streamline billing workflow for processing institutional (UB-04) and CMS claims for a patient, and a fresh, new look for the Kareo brand.

We’re especially excited about the new reporting dashboard, as it will give practices a simple visual of their accounts receivable.  We also like that it goes beyond just charts and graphs to show things the practice can take immediate action on. The first area that allows that is the Top Rejections and Denials lists.  We haven’t seen any other competitive dashboards that give this type of practice info.

The second enhancement we are pleased to announce is the Claim Categories.  This not only shows how many claims exist under each category, but in one click the user is on a work screen where they can take action on those “2” claims ready to bill or “10” rejections awaiting correction.  We think that’s powerful.

And finally, as you saw in the blog post from our CEO and founder Dan Rodrigues, Kareo has launched a new look. We’re very excited about it, and hope that you will tell us what you think.

Here are more details on the release:

Reporting Dashboard

Visualizing the financial health of your practice is now easier than ever. The new reporting dashboard gives you at-a-glance insights about aging, claim accuracy, and claim items needing your attention.

The August Kareo release features a new reporting dashboard, which will give practices a simple visual of their accounts receivable.  The new dashboard displays five key areas of data that will help you easily monitor your accounts receivable status in real-time and take action to reduce your AR balances.

  • AR Passed 120 Days – the figure in the top left shows the dollar amount currently in your 120+ aging bucket and compares that number to your total AR balance.
  • Claim Accuracy – looks at the number of claims billed out over the last 30 days and calculates the rejections and denial percentage.
  • Top Rejections and Top Denials – displays the most common rejections and denials over the past 30 days.
  • Accounts Receivable Aging Graph – shows the amount in your aging buckets for both patient due and insurance due receivables.
  • Claim Categories – identifies actionable claim items across 4 major categories. With a click of a mouse, you or your staff can work the claims within each of these areas.

To access the new dashboard in Kareo, go to the Reports Home page or select Reporting Dashboard from the Key Indicators section of the Reports menu.

View the Reporting Dashboard how-to video.

UB-04 Hybrid Encounter Enhancement

If your practice bills both CMS and UB-04 claims, you know the challenge it is when a patient’s primary and secondary insurance coverage requires different claim formats. In this release, Kareo introduces a new hybrid encounter enhancement that will save you a tremendous amount of time.

The new hybrid encounter allows you to capture all of the data required to submit a CMS and a UB-04 claim from the same patient encounter. Within the encounter screen, you specify which format to use for primary and secondary coverage and then post charges for the visit.

This new feature will significantly help Kareo customers who are Comprehensive Outpatient Rehabilitation Facilities (CORF), Outpatient Rehabilitation Facilities (ORF), and Ambulatory Surgery Centers.

View the Hybrid Encounter how-to video in the Help Center.

The New Image of Kareo

When you login to Kareo or visit the Kareo website, you’ll immediately recognize that something has changed. Over the past few months, Kareo has taken steps to refresh the look and feel of the brand including the logo, the visual style, and our messaging. Even the main Kareo website has undergone significant changes.

Read a note from Dan, Kareo Founder and CEO, where he shares his thoughts on the initiative.

Other Fixes

Below are a few additional tweaks made in Kareo for the August release:

  • Fixed time zone issues for Hawaii (Hawaii-Aleutian) time zone
  • Corrected “Send Coordination of Benefits” claim issue
  • Fixed Patient suffix issue when submitted eligibility inquiries
  • Corrected Box 9 being populated on Medicare secondary paper claims
  • Allow “My Account” access on the help center for locked Kareo accounts
  • Fix Encounter screen validation on submit reason

Help Center Updates

How-To Articles

Updates were made to a hand-full of How-to Articles including:

  • User Accounts
  • Reporting Dashboard
  • New Encounter (hybrid encounter)
  • Practice Information
  • Change Subscription Level
  • New Service Location
  • Company-Wide Clearinghouse Reports
  • Patient Records
  • Departments
  • Encounter Forms
  • Procedure Macros
  • Referring Physicians

How-to Videos

  • Reporting Dashboard
  • UB-04 Hybrid Encounter

At Kareo, we continue working hard to make medical billing easy for you. Customer feedback drives our service and ensures we build the features that matter most to people like you, so your input is critical to us. Please submit your suggestions, challenges and ideas for our next release here – Give Feedback.

Read More | 2 Comments | Filed in Features, Product, Releases

Kareo Introduces a Brand New Look!

August 17th, 2012 by Joann Doan

Dear Kareo Customers,

We are excited to introduce you to the new look of Kareo.  By now, you have likely noticed a change in our logo, and if you visit www.kareo.com, you will experience our new style and messaging.

Why have we made the change?  The Kareo community has doubled each of the past three years and we are now more than 15,000 providers strong.  As we continue to welcome new customers to the service, we decided now is the best time to update our brand to better communicate our strengths and personality.

Though we have a new look and feel at Kareo, you can rest assured that everything else is the same.  Our focus remains, as it has always been, on helping small medical practices and billing services.  Our leadership and staff are unchanged.  And, you will continue to receive the same great product and support you have come to expect from us.

We know a change this big may take some getting used to.  But we hope you come to love the new Kareo brand in the coming days and weeks.  If you’d like to share your feedback on our new look, I encourage you to join the discussion on our Facebook page or customer feedback forum.

We thank you for entrusting Kareo with your business and we will continue working hard to provide your practice or billing service with the tools and support you need to run your business successfully.


Dan Rodrigues,

Founder and CEO of Kareo

Read More | No Comments | Filed in Uncategorized

August Issue of the Kareo Getting Paid Newsletter Details Maximizing Revenue in 2012, More

August 16th, 2012 by Joann Doan

The August issue of the Kareo Getting Paid newsletter, out this week, features great articles on subjects including how to maximize your revenue for the end of 2012, must-do compliance tasks for the small practice, and much more. Take a minute to review these useful articles and also be sure to subscribe to the newsletter so you receive it in your inbox automatically. The articles featured included:

Learn how to improve your appeals and more in the latest issue of the Kareo Getting Paid newsletter

In This Issue / August 2012

Maximizing Your Practice Revenue and Profit in the Home Stretch (Part 1 of 2)

By Laurie Morgan

Maximize Your Practice Revenue and Profit in the Home Stretch of 20122012 is now more than half over. So, now is the time to set your practice up for the home stretch…

Read more

Complimentary Webinar: Finish Strong – Make 2012 Your Most Profitable Year!

Thursday, August 30, 2012
10:00 AM PDT / 1:00 PM EDT
Speaker: Karen Zupko

Register Now

During this fast-paced, dynamic presentation, you’ll learn how to:
Money Man
• Remove redundant steps from your revenue cycle
• Improve point of service collections
• Use modern payment technologies optimally
• Reduce no shows
• And more

Three Must-Do Compliance Tasks for Smaller Practices

By Betsy Nicoletti, M.S., CPC
For smaller groups, compliance duties are shared by several staff members, all of whom have multiple other responsibilities. How to find time? Here are three fast things you can do to protect your practice…
Read more

Physician Productivity Measures Should Include More Than Just RVUs

By Bhagwan Satiani, MD, MBA, FACS, FACHE
Besides RVUs or WRVUs, there are other ways to measure clinical productivity. Unfortunately, a number of physicians are either not aware of the details…
Read more

Medical Billing Tip of the Month

Using the Insurance Collection Summary Report to Increase Provider Cash Flow Effectively

By Henry Richards
EccoHealth LLC

Case Studies

Dr. James Davidson says simply, "Kareo rocks!"“Kareo rocks!”
Dr. Jim Davidson
Lifeline Counseling Center

Medical billing service owner Magdalena Schanck says, "Kareo will save you money and time, and they have great customer service. Switch now."“Kareo will save you money and time, and they have great customer service. Switch now.”
Magdalena Schanck
Magda’s Billing Services

Top News & Ideas from Industry

Physicians Seeing Patient Visits Rebound in 2012
Emily Berry, Amednews, Aug. 6, 2012
Physician visit volume rose by 4.8% over the second quarter of 2012, according to a June 23 research report…
Go to Article

Lawmakers Warned of Demise of Solo Medical Practices
Jennifer Lubell, Amednews, July 30, 2012
Physicians and health analysts testified to lawmakers that growing evidence shows doctors are shutting down their small private practices…
Go to Article

CMS Poised to Release ICD-10 Deadline, Plan Identifier Rule
Joseph Goedert, Health Data Management, Aug. 9, 2012
A final rule delaying the ICD-10 compliance date soon could be issued. CMS has sent the rule for review to the Office of Management and Budget, one of the last steps before publication…
Go to Article

Cloud Computing Expected to Grow Rapidly in Health Care
Emily Berry, Amednews, July 23, 2012
Hospitals and physicians have different uses for the technology, but they are likely to embrace it to save money and share information, experts say…
Go to Article

Medicare Overpayments/Underpayments More Costly in 4th Qtr
AAPC News, July 26, 2012
Providers of health care services to Medicare Parts A and B beneficiaries will pay contractors more in interest for unrecouped overpayments and delinquent unrecouped underpayments in the fourth quarter of 2012…
Go to Article

Insurer Ordered to Stop Asking Physicians to Pay Back Old Claims
Emily Berry, Amednews, July 26, 2012
A California insurance regulator has barred a WellPoint-owned health plan from trying to collect alleged overpayments from physicians based on claims that are more than a year old…
Go to Article

Claims Payment Rule Aims to Cut Red Tape, Save $9B
Bernie Monegain, Healthcare IT News, Aug. 7, 2012
Health and Human Services Secretary Kathleen Sebelius released a new rule she says will cut red tape for doctors, hospitals and health plans, estimating the rule will save up to $9 billion over the next 10 years…
Go to Article

CMS Offers Tips on Assembling an ICD-10 Project Team
Carl Natale , ICD-10Watch.com, Aug. 3, 2012
CMS sent an email this week with tips on assembling a project team responsible for overseeing ICD-10 planning and implementation…
Go to Article

Top 21 Codes for Denied Claims
Molly Gamble, Becker’s ASC Review, July 31, 2012
Here are the top 21 claim adjustment codes, followed by reason codes, reflecting why a claim wasn’t paid or was paid differently than billed. These codes pertain to claims for all specialties…
Go to Article

Suspect Embezzlement? Here’s What to Do
Victoria Stagg Elliott, Amednews, Aug. 13, 2012
Embezzlement is a recurring problem at medical practices. If you think money is sliding out the door with an employee, whom do you call and what do you do?
Go to Article

We hope you enjoy this issue of the newsletter. Be sure to subscribe now to the Kareo Getting Paid newsletter in order to insure you receive future issues.

Read More | No Comments | Filed in Events, General

Like Kareo, Win a Kindle Drawing This Friday – You Could Win! Plus, Be Up on Big Kareo News!

August 13th, 2012 by Joann Doan

Enter the Like Kareo, Win a Kindle drawing now--we'll draw this Friday, August 17!Our next Like Kareo, Win a Kindle drawing is this Friday, August 17, so be sure to “like” Kareo medical billing software on our Facebook page so that you’re entered in the contest. We’ve made a lot of winners happy, and we’d like to have you join that group.

We want to reach 1,000 likes and we’re almost there—so help us out! Plus, we have BIG news coming soon, and we don’t want you to miss it!

We’ll draw a new winner each month, so you have plenty of chances to win!

Like” Kareo now—we hope you win!

Read More | 4 Comments | Filed in Company, Events

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Welcome to Building Kareo, a weblog by the team at Kareo about our products, our partners & competitors, medical billing, healthcare information technology, and much more.


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