It’s that time again! 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 on Thursday December 6th! The winner will receive a $250 American Express Gift Card and the acclaim of their peers. Here are the candidates:
Tip #1: IMPROVE YOUR CASH FLOW—–BE PROACTIVE
- Have the front desk obtain complete demographic and insurance information from the patient.
- When the patient hands in the paperwork or even an updated insurance card to verify that all information is accurate.
- Obtain a copy of the insurance card and driver’s license.
- Check eligibility on the patient before their visit.
- Obtain the patients social security number.
- It makes it easier on the collection agencies to go after unpaid balance from the patient when having the social security number.
- Let the patient know that their patient information is covered under the HIPAA guidelines.
- Collect co pays, deductibles and coinsurances at time of service.
- This will decrease the patient account receivables and patient statements.
- Have check in collect before services are rendered.
- Send out claims daily to insurance carriers
- Once charges are entered that day, claims should be sent out electronically.
- Make sure all payers are set up to go electronic.
- Faster the claims go out, the quicker the money comes in.
- Stay away from paper claims if possible, slower turnaround.
- Accounts Receivables for Insurances follow up
- Have the medical billers follow up on claims by the timely filing on their insurances.
- Have the 90-120 days worked first, to eliminate the timely filing limits.
- Call insurances on unpaid claims, don’t assume they didn’t receive claim and refile..
Following these processes and be proactive should be a smooth sailing for any physician office!!!
Tip #2: Sending NDC information with claims
These are very important because there won’t be any reimbursement for vaccines whether it’s VFC or purchased by the clinic if this is undocumented electronically or on paper. I hope this helps tremendously and promotes an increase in revenue since vaccine prices are increasing and payment for services are decrease. Insurance companies send letters regarding dirty claims with “J” procedure code(s) or vaccine code (s) when the NDC information wasn’t added or documented correctly. To add/correct claims:
- ”Scroll down the page under “Edit Encounter” in Kareo,
- Click the “Miscellaneous (CMS-1500)” arrows to view “E-claim Note Type” at the bottom of the page,
- Click the drop down arrow beside “None” and,
- Select “Additional Information” and the section below opens up to type or copy and paste it in this format e.g. “Hepatitis A NDC 12345-678-900, IM, 0.5 ml”,
- “Save and Rebill” or “Approve” it afterwards so that it will be there forever and submit the claim.
For paper CMS-1500 claims and/or claims that have to be mailed use this format “NDC 12345-678-900 Hepatitis A Intramuscular ML05″ without the N4 qualifier and it’s similar to the e-claims example.
- TIP: Adding the “sticky note” application that is imbedded in most computers is helpful to copy and paste if it’s not documented in the SOAP notes or on the encounter form!
If an EOB or ERA is received and the code is denied or rejected based on the NDC information and you are sure it is in the “Miscellaneous” section just verify the format is correct, BUT BEFORE you rebill it:
- Look at the section where it shows “Submit Reason” under the “Miscellaneous” arrows,
- Choose number “7″ for outpatient offices and type in the claim number; for UnitedHealthcare it starts with “ML…” for BCBS it is the first set of numbers in the third column “Claim Number”.
- Most claim numbers usually start with capital letters but can also be all numbers too for all insurance companies.
Tip #3: Use Kareo AR Report as a tool for tracking issues
So many medical practices are overbooked, have many people doing the same role, may have an outside company handling the billing and need to know where they stand each month with both patient and insurance receivables. Sometimes the role spans across multiple internal and external people so communication is critical in keeping the AR as clean as possible each month.
My company has found that using the Kareo AR detail report and then exporting it to excel is a great tool in tracking issues as well as communicating action items.
- We take the report, export it and then add columns and manipulate the data into working categories.
- We can add comments, assign the owner to the issue and then track its resolution.
- When everyone is on the same page and has accountability the job will always get done in a timely manner. We are the owners of the spreadsheet, the communicators of the action items and the ones who follow up on all of the outstanding AR items each month with each team member.
The ultimate goal is to have a good tracking tool and to make sure all of the key players have the information they need to fix the problem. Once the issue is resolved on the spreadsheet, it is then updated, corrected and/or posted in Kareo. These reports are run each month to show what has been resolved but to also start working on any new issues that have come up.
I hope this report is useful to others and that you will try and work a process around these Aging reports so that you can stay on top of issues before they pass the timely filing requirements or the too late to re-file, etc.
Which tip is your top choice? Vote now on our Facebook page or in the Comments box on this blog. You have until Thursday December 6th, to vote! We’ll announce the winner in our December newsletter.