Cash Flow - Part 2

In part two of a two-part series, AAOE® member Farida Chowdhury, OCSR, the CEO of Medical Billing Strategies, provides five more essential tips for improving your practice’s bottom line.

Getting control of your accounting system and billing cycle is crucial to your practice’s success. By instituting a few key strategies, you can boost your practice profit and increase your practice efficiency.

Cash Flow

5 More Ways To Ensure Positive Cash Flow

I always say, “It’s your money, you’ve earned it.” Here are a few of my top tips to reduce billing errors, resubmissions and rejections to ensure you get the maximum return on your hard-earned money:

Tip 1: Finalize exams and submit claims in a timely manner.

If exam notes aren’t finalized within 24 hours of the visit, a daily reminder must go to the provider, especially if that’s you. If this issue still persists, your biller and manager must meet with the provider (or you) to solve this issue. Any delay in completing exams increases the risk of losing vital health information. Documenting visit notes for treatment on the day of the visit is part of providing good healthcare and building a strong patient base. You will avoid trouble with insurance companies and patients while building increased practice earnings.

Tip 2: Verify claims are clean before submission.

Before submitting any claim to insurance, your billers must do their own auditing of the exam notes. The claim itself is just a single sheet of paper with concise information, mostly with codes and numbers, which tells a detailed account of the visit from the first phone call to the end of visit. Before submission, make it a routine to ask, “Do I have the proper documentation to back up the claim?”

Tip 3: Every test should have supporting documentation of need.

Every plan has its own coverage policy for diagnostic testing. Before your practice does any test on the patient, be sure the physician, technician, and biller first ask, “Who is paying?” Your billing team must maintain current Local Coverage Determination (LCD) lists for tests performed at your practice. No matter how much you feel it’s necessary to perform a test, if it is not covered under insurance LCD, it will not be paid. In cases where you feel a test that’s not covered is absolutely necessary, consider getting a waiver/ABN signed by the patient and clearly explain why it’s important for their health.

Tip 4: Review your insurance aging report regularly

Insurance Aging must be reviewed on a fixed interval for two purposes. First, to make sure correct (or corrected) information has been sent, related notes are in the patient’s file and a corrected claim (if needed) has been submitted. Second, regular review of insurance non-pays will give your billing team the opportunity to find rejection patterns and avoid the same mistakes in future and bring in payments for all claims. Your goal is to get all claims paid under 60 days.

Tip 5: 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 miss the first article of this two-part series: Cash Flow : Ways To Ensure You Get All Of It All The Time (Part 1 Of 2)

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