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Time to Vote for the Medical Billing Tip of the Month!

April 25th, 2012 by Kathy McCoy

Vote for your favorite tip for our Medical Billing Tip of the Month!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, May 2! The winner will receive a $250 American Express Gift Card and the acclaim of their peers. Here are the candidates:

1. Missing a Procedure Code?

If Kareo does not have the procedure you are looking for, there is an easy fix. Go to “Settings” at the top of the page and then highlight “Codes.”  From there you will want to select “New Procedures.”  From this window you can add not only the code itself, but some basic information to go along with it, including the default units.  This has allowed our clinic to include charges that we otherwise would have been unable to bill for, resulting in boosted revenue.

You can also add procedure modifiers under the code menu.  As we are a physical therapy clinic, we needed to include the “GP” modifier, which was not included with the other modifiers.  A quick and easy fix, and we have been able to easily bill through Kareo.

 

2. Quickly Find “Pend/Review Clearinghouse” Responses

We search and review our clearinghouse reports for information such as:

Payer pend/request info – investigating existence of other insurance coverage

and

Pend/review – internal review/audit

That way we can work our claims faster than awaiting a zero payment or notification letter from the insurance company.

 

3.     Making the Best Use of the Hot Keys

We all know that when we can speed up our processes, we accomplish more.  The results of better productivity mean a healthier medical practice or billing company.

If you take time to learn your Hot Keys in Kareo (Those F keys with numbers), and use them, you can speed up your processes.  This is really helpful when you are using the keyboard and want to save time and hand movements by not having to reach for the mouse.

Here is a Hot Key guide for you:

F1       This is the Help Key.  This takes you right to the Kareo help guide.  Here you can access the knowledge you need for those issues you are struggling with.  You do not need to leave what you are doing, as this guide pops up as a small window.  Once you have opened the guide, you will need your mouse to access the information and close the window.

These next keys are for all things new:

F2        Entering a new Patient?  Use this key first.

F3        Here you can create a new appointment.

F4        Doing Charge Entry?  This is your New Encounter screen.

F5        Make a new payment with this key.

F6        Go right to the Scan Document Screen with this hot key.

Our next group of Hot Keys is for existing Information.  You will notice they are the next five keys up from the “new” keys:

F7        Find a patient.  (See, F2 is five keys up from here.)

F8        Already created your appointment at F3?  Now you can use this key to find it.

F9        This is five up from the new encounter screen, now go find an encounter.

F10      Find a payment.  You might use this key a lot.

F11      You can find the already scanned documents using this key.

The next Hot Key is special and does not fit the “five keys up” rule.

F12      This is the Find Task key.  If you have tasks for certain days and times, this is where you can find them.

Well, we have used up the “F” Hot Keys, so how do we go to the Find Claim Screen?  Check this out:

Ctrl+ Shift + C         Push all three keys at the same time. You can find the claim you need here.

Now for the Hot Key that streamlines your Kareo processes: 

Esc      After being in Kareo for a while, you may find yourself with screens that just get in the way.  If you are through with a screen, you can simply hit the Esc key and remove the unwanted screen.

Which tip is your top choice? Vote now on our Facebook page or in the Comments box on this blog. You have until Wednesday, May 2, to vote! We’ll announce the winner in our May newsletter.

Read More | No Comments | Filed in Events, Features

Do You Understand RVUs? And Other Important Questions We’re Answering

April 23rd, 2012 by Kathy McCoy

Join expert Sara Larch for an explanation of how RVUs are calculated and how to use them to improve your practice's bottom lineRVUs: Three little letters representing a subject that many practice staff do not understand, and yet they heavily impact how the practice is paid. “RVU” stands for Relative Value Unit; under the Resource-Based Relative Value System, Medicare assigns a Relative Value Unit (RVU) to each procedure code in order to estimate the relative complexity of one procedure to another.

Did you know that when you build your standard fee schedule in Kareo, you can load in the RVU for each procedure code as set by Medicare? And why is this important? Because many practices now take advantage of the relative value scale as a way of more accurately measuring the productivity of physicians.

But if you don’t understand how RVUs are calculated and used, you won’t be able to use this feature in Kareo—or to understand how to effectively evaluate your payers, as Frank Cohen explained in our webinar last week in “Getting Paid Accurately: What the National Health Insurer Report Card Means to Your Practice and How You Get Paid.” In this extremely valuable webinar, Frank explained the importance of evaluating your payers using various factor, including RVUs, that give you the best picture of the payers’ true value to your practice.

In our upcoming webinar, “Using RVUs to Improve Your Bottom Line,” expert author and practice management expert Sara Larch, MSHA, FACMPE, will give you an overview of why RVUs are important to your practice and how to use them to improve the medical practice’s profitability.

Attendees in this webinar will learn:

  • How RVUs are calculated
  • Why using RVUs improves the quality of your analysis
  • How to use RVUs in reimbursement analysis
  • “Best Practices” in RVU benchmarking

Sara Larch, MSHA, FACMPE, principal, Business of Medicine and co-author of “The Physician Billing Process: 12 Potholes to Avoid in the Road to Getting Paid,” will describe key methods for managing RVUs to improve your bottom line.

For more information on RVUs and their importance to your practice, read “Understanding the RVU in Practice Management: Getting the Most Out of Using It in Your Practice,” a very popular post on our blog.

Then register for Using RVUs to Improve Your Bottom Line to understand how to utilize this important tool to increase your practice profitability.

Read More | 2 Comments | Filed in Events, Features

Enhancements to Kareo for April: Medicare Fee Schedule Import, Duplicate Claim Warning and More

April 16th, 2012 by Kathy McCoy

On Friday, April 13th, all Kareo accounts were upgraded to the latest Kareo version. Several key improvements have been made to make it easier to import the Medicare fee schedule, easier to track activity in within a patient’s record, and easier to identify duplicate claims before submitting to payers.

New Medicare Fee Schedule Import

Quickly import Medicare fee schedule directly from CMS

              • Quickly import Medicare fee schedule directly from CMS.
              • Easily select the year, effective date, and your state.

Read more
 
 
Patient Information Audit Log

A new patient audit log has been created within Kareo to track the user, date, and time of key actions taken within a patient’s record.

Read more

Duplicate Claim Warning

A new warning has been added to alert you if you are attempting to resubmit a claim for an encounter that already has a claim in process.

A new warning has been added to alert you if you are attempting to resubmit a claim for an encounter that already has a claim in process.

Read more

 

Additional Fixes & Enhancements

Improvements to the Kareo setup wizard have been made to make it really easy for new customers to set up practice locations, providers, and insurance payers.

Read more

Help Center Updates

Learn more about the enhancements in this release through new training courses, videos, and how-to articles.

Learn more about the enhancements in this release through new training courses, videos, and how-to articles.

Read more

At Kareo, we continue working hard to make medical billing easy for you. Customer feedback drives our service and ensures we build the features that matter most to people like you, so your input is critical to us. Please submit your suggestions, challenges and ideas for our next release to GIVE FEEDBACK.

Read More | No Comments | Filed in Features, Releases

April Issue of Kareo Getting Paid Newsletter Features Articles on Getting Every Penny You Deserve, Modifier 33, and More

April 10th, 2012 by Kathy McCoy

The April issue of the Kareo Getting Paid newsletter just went out this morning, and it featured a lot of great articles on subjects including the National Health Insurer Report Card and getting paid what you deserve, internal controls for your practice, and much more. Take a minute to review these useful articles and also be sure to subscribe to the newsletter so you receive it in your inbox automatically. The articles featured included:

Latest from Kareo

Managing Underpayments in Medical Billing: Getting Every Penny You Deserve

With today’s complex coding and reimbursement systems, it came as no surprise to discover that payment accuracy rates among insurance companies dip as low as 62.08%. That finding comes from the AMA’s National Health Insurer Report CardBy Elizabeth W. Woodcock, MBA, FACMPE, CPC

With today’s complex coding and reimbursement systems, it came as no surprise to discover that payment accuracy rates among insurance companies dip as low as 62.08%. That finding comes from the AMA’s National Health Insurer Report Card, and the results are, arguably, alarming… Read More

Complimentary Webinar: Getting Paid Accurately – What the National Health Insurer Report Card Means to Your Practice and How You Get Paid

Hear from Frank Cohen, one of the architects and the lead analyst/statistician for the National Health Insurer Report Card, on what the NHIRC means for your practice profitabilityThursday, April 19, 2012
1:00 PM EDT/10:00 AM PDT
Speaker: Frank Cohen

Did you know that the AMA’s National Health Insurer Report Card (NHIRC) for 2011 revealed you may be paid accurately what you are contractually owed as little as 62% of the time? In this webinar, hear from Frank Cohen, one of the architects of the NHIRC, on what the NHIRC means for your practice profitability and how you can use the information to improve your denial rates and your revenue… Read More

NEW! Kareo’s Resource Center Now Provides Free Webinars, White Papers and More

The new Kareo Resource Center offers free tools for improving profitability in your medical practice. Materials in the Resource Center are authored by recognized industry expertsBy Kathy McCoy

Kareo’s new Resource Center offers free tools for improving profitability in your medical practice. Materials in the Resource Center are authored by recognized industry experts… Read More

Compare and Contrast: Modifier 33 and Modifier PT

By Betsy Nicoletti, M.S., CPC

Remember in high school when your teacher assigned “compare and contrast” essays?   This article will compare and contrast two recently added modifiers, Modifier 33 and Modifier PT… Read More

Internal Controls: Keys to Avoiding Medical Practice Embezzlement

By Laurie Morgan, Capko & Company

Did you know that by most estimates, more than 80% of medical practices will at some point suffer losses from embezzlement? Whether you are a practice manager or physician owner, you have a role to play and an interest in protecting your practice’s financial health from internal theft… Read More

Four Vendor Questions to Ask Before You Buy Your EHR

By Ron Sterling

Once you have made your EHR selection, you need to ask some key questions to assure your vendor plans to meet your needs and what your practice will need to do… Read More

Breaking News: HHS Proposes Delaying ICD-10 Deadline to
Oct. 1, 2014

By Kathy McCoy

A proposed rule from HHS pushes the compliance deadline for conversion to ICD-10 back by one year to Oct. 1, 2014. HHS Secretary Kathleen Sebelius announced… Read More

Case Study

“Kareo got us out of claims purgatory and helped save us thousands of dollars!”

Jill Foote, Lifestyle Resumption: “Kareo got us out of claims purgatory and helped save us thousands of dollars!” Jill Foote, Lifestyle Resumption

Jill Foote, Billing Specialist at a chiropractic practice, knew something was wrong. The charges being generated by her clinicians weren’t all making it back to the practice coffers as reimbursement… Read More

Case Study

“Kareo is a huge timesaver and has allowed me to offer a much better service to my clients.”

Vanessa Higgins, The Billing Department, LLC: “Kareo is a huge timesaver and has allowed me to offer a much better service to my clients.” Vanessa Higgins, The Billing Department, LLC

After owning her own billing company for 14 years, Vanessa Higgins concluded two years ago that she needed new medical billing software. “I knew if I was going to continue to grow my company, I needed software my clients could access… Read More

Billing Tip of the Month

ERA Tracking for the Payment Method Code of “Check”

Scott Benjamin, ECCOHealth

We receive ERAs from the carrier with the payment method code “Check” and need to track this type of ERA to confirm the check has been sent to the provider’s correct address and to be sure the check was cashed by the provider… Read More

Top News and Ideas from Industry

CMS Backlog Shortchanges Doctors on E-Prescribing Exemptions

Charles Fiegl, Amednews, April 9, 2012

Some physicians are reporting that the Medicare payments they’ve received for their services in 2012 are being reduced for a failure to prescribe enough electronically in 2011, even though the doctors filed waiver requests seeking special hardship exemptions… Read More

Americans Cutting Back on Drugs and Doctor Visits

Katie Thomas, New York Times, April 4, 2012

Patients cut back on prescription drugs and doctor visits last year, a sign that many Americans are still struggling to pay for health care, according to a study released Wednesday by a health industry research group… Read More

Employers Signal Near-Term Cuts to Employees’ Health Benefits

Emily Berry, Amednews, April 2, 2012

Facing the last few years before major health reform elements kick in, most employers say they are paring back benefits and pushing more costs to employees. Continued pressure on benefits could hurt physician practices if patient volumes continue to slow, as they have since 2007… Read More

PQRS Measure 235 Causes Rejections

AAPC News, March 29, 2012

An error related to the submission of measure 235 “Hypertension: Plan of Care” for the 2012 Physician Quality Reporting System (PQRS) is causing Medicare Part B claims containing the codes associated with the claims/registry measure to be rejected or denied… Read More

Can a Specialty Practice Be a Patient-Centered Medical Home?

Victoria Stagg Elliott, Amednews, April 9, 2012

Should cardiologists, oncologists, endocrinologists and other specialists providing care for long-term chronic conditions have patient-centered medical homes? Those working on the patient-centered medical home concept say specialty practices need to consider several issues before moving forward… Read More

CMS: Medicare Reimbursement Rates Won’t Be Cut in 2012

AAPC News, March 29, 2012

The Centers for Medicare & Medicaid Services (CMS) Transmittal 1058, Change Request (CR) 7767 confirms a zero percent update for payments under the Medicare Physician Fee Schedule (MPFS) through year’s end. Also included in the MCTRJCA are extensions to… Read More

MedPAC: Toss SGR and Replace with Freeze

AAPC News, March 29, 2012

The Medicare Payment Advisory Commission’s (MedPAC’s) report to Congress regarding Medicare’s fee-for-service payment system is clear: Replace the sustainable growth rate (SGR) with specified updates not including an expenditure-control formula… Read More

Clinical Documentation Improvement: Why It’s Needed Before ICD-10 Implementation

Carl Natale, IDC-10 Watch, March 28, 2012

One of the reasons why ICD-10 implementation will be a major change for hospitals and medical practices is documentation. Clinicians will need to improve documentation so diagnoses and procedures can be coded to the highest level of specificity… Read More

5 Steps Toward HIPAA Security

AAPC News, March 28th, 2012

Ensuring security of electronic personal health information (PHI) is tough. A more stringent HIPAA Security Rule and news of PHI breaches raises anxiety in billing offices. In a recent interview in Healthcare IT News, Mahmood Sher-Jan, vice president at ID Experts, shares these tips… Read More

Don’t Let Missed Appointments Reduce Your Bottom Line

Deli Parham, CPC, AAPC News, March 28, 2012

Missed appointments—no-shows and last minute cancellations—plague every practice. Some practices charge to recoup revenue for missed appointments while using the threat to motivate patients to keep appointments. Others don’t. Here are some tips… Read More

7 Steps to Improve Productivity and Efficiency: How to Master the Art of Office Triage

George G. Ellis Jr., MD, FACP, Medical Economics, March 10, 2012

In my practice, we have instituted a seven-step process that has improved my productivity by approximately 25%. The use of an electronic health record (EHR) system has been an invaluable asset in my ability to improve productivity and profitability… Read More

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Read More | No Comments | Filed in Company, Events, Features

Claims Processing Errors: Combating a Business Epidemic

April 2nd, 2012 by Jason McDonald

The rate for claims processing errors for health insurers now averages 19.3 percent, according to the AMAImagine buying an $800 TV with a $1,000 bill, and getting only $1 back in change. No one would accept being duped out of nearly 20 percent of their hard-earned cash—yet that is exactly the scenario practices are facing with commercial insurance companies in 2012. According to the American Medical Association’s (AMA) fourth annual National Health Insurer Report Card, the rate for claims processing errors for health insurers now  averages 19.3 percent, according to data released in 2011. To be very clear, the data doesn’t tell us that the insurance companies are paying 20% below what their contracts require them to pay. Instead, the data states that 20% of the time, insurance companies are not paying precisely what they’re supposed to pay.

What does this mean for the average medical practice?  Whenever there’s a chance that physicians are being paid below their contracted rates, it forces them to drain resources that could otherwise go to patient care because they are worrying about underpayments and overpayments.  At its best, it creates unnecessary distraction.  At its worst, it threatens the financial stability of the practice.

The AMA’s latest findings also show that, overall, commercial health insurers have experienced an increase of two percent in their error rate compared to 2010. This is tantamount to a business epidemic in health care: The increase in overall inaccuracy represents an extra 3.6 million in erroneous claims payments compared to last year, and added an estimated $1.5 billion in unnecessary administrative costs to the health system. Yet most of the health insurers measured by the AMA failed to improve their accuracy rating since last year.

“A 20 percent error rate among health insurers represents an intolerable level of inefficiency that wastes an estimated $17 billion annually,” said AMA Board Member Barbara L. McAneny, M.D. in response the findings published in June 2011. “Health insurers must put more effort into paying claims correctly the first time to save precious health care dollars and reduce unnecessary administrative tasks that take time and resources away from patient care.”

Claims processing errors not only waste billions of dollars, they frustrate patients and physicians alike. Errors divert practice resources away from patient service because staff must spend more time dealing with duplications in effort. According to a 2008 MGMA digest article, the potential cost of a claim resubmission–including phone inquiries, duplications and extra administrative expenses–can be $57.46 per claim.  Multiply that figure by twenty percent of your own yearly patient volume, and you can see the potential real-time cost in dollars to your practice.

Tools For Combating A Business Epidemic

Unfortunately, many practices may not even be aware that they are being underpaid. The problem is so prevalent that the AMA prepared a primer on the issue, Appeal That Claim. It provides a blueprint for auditing and appealing claims within the practice setting. Most reputable practice management software vendors have the capability to allow practices to load payer-specific fee schedules, and audit incoming payments against those fee schedules.  Here’s a video that reflects how Kareo equips practices to deal with the business epidemic of insurance underpayments.  Can such functionality really make a difference? Yes.

In one instance cited in the AMA document, health insurers consistently underpaid a practice in Chicago by $928.50 per claim for a commonly performed procedure. The same document indicated that yet another practice could have recovered as much as $91,000 for a single type of procedure over a period of 3 years if it had effectively audited and appealed claims. Within 5 months of implementing an effective auditing and appeals process, another practice was recovering as much as $100,000/month.

Consistently auditing your claims for accuracy against contractual rates is not the only strategy you can take to improve your reimbursement. Physicians received no payment at all from commercial health insurers on nearly 23 percent of claims they submitted. There are many reasons a legitimate claim may go unpaid by an insurer. Lack of patient eligibility for medical services continues to be the most frequent reason for denials. To wit: During February and March of this year, the most common reason insurers didn’t issue a payment was due to deductible requirements that shift payment responsibility to patients—and they had not yet met their deductible.

Once again, the right software functionality can help practices minimize the risk of underpayment.  Electronic real time insurance verification is the best way to determine if patients have met their deductible. This saves practices the wasted administrative expense of billing the insurance payer, only to have the claim denied. It also saves the time and expense of having to follow-up by sending the patient a billing statement. Kareo helps fight denials for the most common reason with real time insurance eligibility.

To help practices deal with the  business epidemic of insurance underpayment, Kareo will be sponsoring a free webinar entitled “Getting Paid Accurately: What the National Health Insurer Report Card Means to Your Practice and How You Get Paid” on April 19. Register now to learn more about the impact of insurance underpayment and what you can do to protect your practice.

Read More | 4 Comments | Filed in Features, Product

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Welcome to Building Kareo, a weblog by the team at Kareo about our products, our partners & competitors, medical billing, healthcare information technology, and much more.

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