We’re pleased to announce that the winner of our first “Medical Billing Tip of the Month” contest and recipient of a $250 American Express gift card is AJ Riviezzo, MBA, who is CEO of American Physician Financial Solutions, LLC.
We received many excellent tips on how to streamline the medical billing process and better use medical billing software, and we thank everyone for their submissions. Below you will find the winning tip, as selected by our judging committee, and the two runners up.
Billing Tip of the Month Winner:
Pro-Active Notes Process Decreases Time to Payment on Elective Procedures
Many elective procedures require not only a preauthorization, but are frequently subject to review post- procedure. This review typically consists of sending documentation to the payer for their review. Examples of said documentation may include any diagnostic laboratory or radiology studies, the operative reports, and perhaps a Letter of Medical Necessity.
Waiting until the claim has processed and been denied with a request for notes can significantly delay payment. If these types of procedures are a large part of your practice, your accounts receivables have just increased by quite a number of days.
Our recommendation is to note which payers are typically requesting the aforementioned notes. Once that it is identified, we then begin to send notes in a proactive fashion. We submit the claim electronically through Kareo medical billing software. One week after the claim has been received by the payer, we send the notes (either fax or snail mail depending upon the payer) to the payer. When we receive the EOB stating notes are required/zero pay, we call the payer and indicate that notes should already be on file and ‘force’ them to reopen the claim right then.
This process has helped decrease the time to payment on these elective procedures.
AJ Riviezzo, MBA
CEO, American Physician Financial Solutions, LLC
719.233.0099
Quick Method for Checking Rejections, Denials & “No Response” Claims
1. In Kareo, go to “Track Claims” status.
2. Change drop down from “All Claims” to “Rejections” and hit “Find Now.” This will pull all patients that had some kind of error in sending out the claims.
3. Double click on the patient name and it will open the claim so you can review the clearinghouse response. Scroll down to the last responses and read through them to see the reason it was rejected. This doesn’t always show up on the clearinghouse reports. Once you’ve identified the issues, you can deal with each rejection appropriately.
4. After reviewing these claims, then you can change the drop down to “Denials” and do the same thing again.
5. Change the drop down to “No Response” and go through these claims. (Some of these have not been denied but should be reviewed as the system has marked them as an error.)
This will help cut through the A/R faster and keep current claims moving through A/R.
Kathleen Cancilla
AllDocuments, Inc.
(650) 556-1000
Reducing A/R By Checking for Co-Pays in Advance
One of the best ways to improve collections is to run your patient list for that day or a couple days ahead and check for co-pays for insurance. Also check the Kareo system for outstanding balances. At the office, we have the patient face to face and need to make them aware of the balances due for services rendered. I have found this to be a very good way to keep our A/R down and the doctor happy. Most patients want to pay so they do not get behind.
I have been doing this for the past 20 years that I have been in the medical setting. It seems to be just good business.
Barbara Jones
Submit Your Entry for the August Medical Billing Tip of the Month Contest
If you would like the opportunity to win $250 and get your company name in front of thousands of potential customers, enter our Billing Tip of the Month contest for August. Just submit your best billing tip by July 26 via email to Marketing@Kareo.com. We’ll announce the winner by August 11 and will post the best tips on our website and in our monthly e-newsletter, giving you and your company credit. (Please be sure to list your company name in your entry!).
Good luck!
