You be the judge for 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, August 7! The winner will receive a $250 American Express Gift Card and the acclaim of their peers. Here are the candidates:

1. Using Insurance Collection Summary Report to Increase Provider Cash Flow Effectively

We are using the Kareo insurance collection summary report to work on the High Dollar claims, Old Aging claims, Top 10 payers aging, etc. Here is the report customization for your reference.

Go to Reports -> Accounts Receivable -> Insurance collection summary -> use “Customize” tab to obtain the reports per your Priority. Please customize the option as described below:

Age:             30+

Status:          All

Grp By:          Patient

Sub Grp By:   Patient

Sort by:  Balance

Report Format:

First report: You will get a report based on the Patient total value by Descending to Ascending order. Once the report is generated, we can start attacking the High dollar claims to get the best reimbursement for the provider. The provider will be very concerned about his High dollar value claims which have been submitted to the carrier. By generating and working on this report, we can increase the payment flow of the provider drastically. The output of the report will be generated as mentioned above format. The Top 100 patient claims will cover most of your insurance aging. By working on these claims effectively, you can see a drastic change in the payment flow.

Second report: Use the same report, by changing the “Group By” status to “Insurance Plan.”  The report gets sorted based on the Total outstanding aging for a payer by Descending to Ascending value of claims for a particular payer. By using this report, we can work on the Top 10 payers’ aging and reduce the aging of particular payers effectively.

Third reportUse the same report, by changing the “Subgroup by” status to “Insurance Plan.”  The report generates the patient claims which have High Dollar value, including the payer name.

Note: By using the collection summary report effectively, cash flow for the provider will increase effectively and we can concentrate on high billed claims. We can reduce the high value claims moving to 60+ aging. Please make use of this report to improve your cash flow.

2. Billing Miscellaneous Codes on a Separate Encounter

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. Calculating Total Rejected Claims by Numbers and Amount for a Month & Reducing Them

To run a rejected claims report with # of claims and by value, we need to manually check all the clearinghouse reports for the month received to find the total rejected claims.  However there is a possible way to find only the rejections count and total in clearinghouse report. Here’s how:

Go to Clearinghouse report -> select Claim processing section – > Type R: in the look for tab -> Find now.

Now you see list of claims submitted in Claims column and Rejected claims in the second column (Only Rejected claims clearing house reports – 20 line items in a page).

For example: The claims submitted are 22 and rejected 4, the total value of the rejected is mentioned as R:4 / $2914.00. The number and value mentioned in the same line. Please see the highlighted. ( P 18 – accepted claims & R: 4 – Rejected claim).

Conclusion: You can use this simple exercise to calculate the total rejected claims for a month and take necessary action to avoid such rejections in future months. We are using this to control repeated rejections and educating the team effectively to avoid the same error in future. This also helps us to improve the “First pass ratio” percentage. Avoid the Duplicate rejection count showing the report while calculating.

Which tip is your top choice? Vote now on our Facebook page or in the Comments box on this blog. You have until Wednesday, August 7, to vote! We’ll announce the winner in our August newsletter.