Medical Coding and Billing Intelligence

Your medical coding and billing is the lifeblood of your business. Every penny that is sitting in your accounts payable file is your money and should be in your account. For openers, what percent of your accounts receivables is in arrears? As good as your practice is, you should never let your outstanding receivables be more than 2% (!) of the total. Yes, that is an industry standard and, yes, you can get there. Here are a couple of suggestions to keep your medical collections up to date.

Verify Patient Coverage Plans Beforehand

Insurance plans are like alphabet soup: PPO, HMO, POS, EPO, HDHP, HSA, not to mention primary, secondary, territory, and many others. If you treat patients without identifying their exact insurance plan and coverage, and most importantly, without verifying whether you participate with the particular plan, you run a great risk of not getting reimbursed for your work.

Medical Coding and Billing Intelligence

Stay Current on HIPAA and Insurance Company Rules and Requirements

Going through an insurance audit is a very painful process. You must keep updated on rules and regulations of all insurances, as well as federal and local government laws. Rules and laws are updated throughout the year, so do not take the printout from last year for granted or apply one company’s rules to another. Stay current on insurance rules, they may change frequently. Failure to run your practice according to HIPAA guidelines is both unacceptable and a malpractice risk. Your own compliant plan should work as an owner’s manual for everyone in the practice.

Don’t Fall Behind on Billing or Collections

You’ve already worked for that money – make collecting it your #1 priority. Your billing team should start each day identifying unpaid invoices. Is the insurance company behind? Is there a procedure error or billing error?

As I have written before, most outstanding billing problems are a result of a procedure error in your own company. Or, if you’re using an outside medical billing company, you should hold them accountable for any unnecessary delays.

Start now. Stay on top of it. And you will see an immediate return on your investment of time and effort.

If you’d like to know more, drop me a note and I’ll be happy to respond.

Portions of this blog originally appeared in the AAO Practice Express

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