Medical Billing Tip of the Month

Kareo Newsletter Is a Medical Practice Management Must Read!

Kareo March 12th, 2013

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The March edition of the Getting Paid Newsletter is out. This month’s issue is full of great medical practice management topics and tools from EHR implementation to patient flow tracking. Laurie Morgan, MBA, reviews some simple techniques to get started marketing your medical practice. Ron Sterling, an EHR expert, reviews the 6 Features Small Practices Need when selecting an EHR. And, Rico Lopez, Senior Market Advisor at Kareo, guides you through an analysis of your patient flow and how to know if it is hurting your medical practice. In addition, there is information about our upcoming free webinar, Marketing for Medical Practice Profitability, and a chance to win $150. So, if you haven’t already read it, check it out now!

Kareo January 8th, 2013

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The January issue of the Kareo Getting Paid newsletter, out this week, features great articles on the transitional care management services and medical billing tips for the new year. 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.

In This Issue

Wondering about Transitional Care Management Services? Wonder No More!
by: Betsy Nicoletti, MS, CPC
Many medical practices have heard the news: CMS will recognize new non-face-to-face services in 2013. The new Transitional Care Management Services (TCM) codes defined by CPT and recognized by CMS will provide an opportunity for physicians to be paid for work done coordinating the care of patients discharged from a facility and returning to the community. Read more…

Start the New Year Right … Don’t Let Deductibles Stand in the Way
The fact is that healthcare is changing, and that means new challenges and opportunities. The annual deductible reset may not have to stand in your way. The healthcare reform law includes coverage for a wide range of preventive care
services. Unfortunately, not everyone who has insurance knows that or is taking advantage of it. Read more…

Kareo’s Top 12 Medical Billing Tips of 2012
As we head into 2013, let’s not forget about some of the great tools, tips, and tricks we learned from a few of the industry experts who shared their knowledge with us through blog posts and webinars in 2012. Read more…

Case Study

“Kareo has enabled me to treat my patients efficiently and to also get paid for them in a timely manner.”
Jim Denton, Owner and Physical Therapist
Total Joint and Orthopedic Physical Therapy

Educational Webinar:
Everything You Need to Know about Transitional Care Management Services
Thursday, January 15, 2012
10:00 AM – 11:00 AM PST
Betsy Nicoletti, MS, CPC

Register Now

This webinar will provide you with all the information you need to take advantage of the revenue opportunity created by the new transitional care management services codes.

1 PAHCOM CEU Credit for attending live.

Kareo in the News

Just Because It’s Expensive, Doesn’t Mean It’s the Best
Andrew Bronstein, MD, a Kareo user, authors a guest column where he discussed his experience choosing a practice management system.

Top News & Ideas from the Industry

Ten Ways Patients Get Treated Better
“Experts increasingly are adopting new ways to treat patients that studies show are better at healing the sick, preventing disease, improving patients’ quality of life and lowering costs. Here are 10 innovations that took root in 2012.”
Wall Street Journal, 12/17/12

EHR Adoption & Meaningful Use Progress is Assessed in New Data Briefs
Two recent data briefs reported strong growth in electronic health record (EHR) adoption rates among physicians … and substantial growth in nearly all the individual functionalities associated with “Meaningful Use.”
HealthIT.gov, 12/19/12

HHS Launches Privacy Campaign
The Department of Health and Human Services has launched a mobile health privacy and security education campaign, aimed at giving a framework for providers just starting to use mobile devices.
Healthcare IT News, 12/21/12

Doctors Lean Local in Joining Health Information Exchanges
More small startups are competing with statewide or regional exchanges for physician business, a report finds.
American Medical News, 12/24/12

Trends in Health IT Adoption Among Physicians
The correlation between physician age and technology adoption is very real — and the reasons for it very complex. Here’s how practices can get doctors of all ages on the same page.
Physicians Practice, 12/31/12

Joann Doan November 12th, 2012

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Our judges (you) have spoken, and we have our Medical Billing Tip of the Month for November. We received a terrific volume of votes! Thank you to everyone who voted on our blog and Facebook. The winner of our Medical Billing Tip of the Month contest this month is…

Billing Tip #3:

3. Creating Cases for Authorization

In Psychiatry specialty, most of the procedure codes would require Authorization, especially from Medicaid, Sierra and Amerigroup insurances. There is an option in Kareo to update the Authorization information alright, but a little more enhancement that I described below will ease the process of submitting the claims with appropriate authorization without any hindrance.

- Create separate cases for each CPT code that require authorization. For eg., if a patient has CPTs 90806 and 90847, we can create 2 separate cases with the names “90806″ and “90847″

- Whenever a service is performed, it can be entered into their respective cases. In cases where a patient has a month-over-month policy, the case can be named with a suffix, for eg., “90806 – Medicaid”, “90847 – Sierra” and so on

- This will actually eliminate assigning an incorrect authorization# for a CPT

-Also, when a “Patient Insurance Authorization” report is generated, this will give a clear picture of which authorization # is valid for which CPT.

Dan Gillmore

Congratulations Dan! We’re throwing out the challenge to our many other fine billers, billing services and billing managers: Send your tips in, and you could win the $250 prize!

Please be sure to submit your Medical Billing Tip of the Month to Marketing@Kareo.com for inclusion in the next round of judging. We’ll post the top three tips on our Facebook page and on the Kareo blog for your vote! You will win a $250 American Express gift card if your tip is chosen. Good luck!

Joann Doan October 8th, 2012

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Our judges (you) have spoken, and we have our Medical Billing Tip of the Month. We received a terrific volume of votes! Thank you to everyone who voted on our blog and Facebook. The winner of our Medical Billing Tip of the Month contest this month is…

How to increase Provider payment flow using KEY INDICATOR SUMMARY effectively.

Reports – > Key indicator -> Key indicator Summary – Fill date (01/01/12) to (08/31/2012). – Just click the REFRESH to run the report

•The generated reports shows the total encounter, charges, Adjustments, Receipts & other from Jan 2012 – Aug 2012.

•Just click, the charge total and you will see the list of CPT performed by the provider from Jan 2012 – Aug 2012 with the total billed amt.(Refer the below screen shot).

•Here is the drill down of the charges.

•Go to Customize tab and select the “Measure type” as UNIT COUNT and generate the report.

•Now the reports shows, the total count of each CPT performed by the provider from Jan 2012 – Aug 2012.

•Generate the report into excel format such as “CPT, Total CPT count and add another column as “Medicare Allowable”.

•Then update the Medicare allowable for each code by checking the Medicare fee schedule or Use V-look up formula.

•Sort the Medicare allowable value from Descending order.

•Once the Medicare allowable is updated in the list and again sort the report for the CPT in descending order.

•By sorting it, you can find the provider most performing codes as well as highly paid Medicare allowable codes.

•Now check the Top 25 CPT which has high Medicare allowable in the list.

•If the Highly paid Medicare allowable (CPT count performed by Provider) is less, Escalate / submit the report to the Provider to perform those CPT’s constantly.

•The report will helps the provider to perform more CPT which has high reimbursement.

•The Cash flow of the provider will gradually increase month over month by using this report effectively.

Conclusion:

This Kareo report is very useful for the Provider to compare his CPT performance month over month as well to increase the cash flow. The report will be very effective for the specialty based Provider.

Henry Richards
EccoHealth LLC

Henry, you’re on a winning streak!—Congratulations! But we’re throwing out the challenge to our many other fine billers, billing services and billing managers: Send your tips in, and you could win the $250 prize!

Please be sure to submit your Medical Billing Tip of the Month to Marketing@Kareo.com by October 26th, for inclusion in the next round of judging. We’ll post the top three tips on our Facebook page and on the Kareo blog for your vote! You will win a $250 American Express gift card if your tip is chosen. Good luck!

Kareo September 10th, 2012

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Control the Top 10 Internal & External Denials Using the Denial Summary Report

We are using the Denial summary report to control the internal and external denials in our providers’ practices

Go to Reports > Payments > Denial Summary > Change the date to “Year to date.”

By generating the report, you can view the claims denied with the denial code and the total amount. Just generate the report into an Excel spreadsheet and sort the denials in descending order by total amount. You can also drill down to the billed amount to review the CPT and the carrier for a particular denial code. Then categorize whether the denial is internal or external. Here is the report for reference:

For example: Co-22 – Payment adjusted because this care may be covered by another payer per coordination of benefits.

Ex: C0-26 – Expenses incurred prior to coverage.

Ex: Co-27 – Expenses incurred after coverage terminated

Internal Denial: The above denial is related to eligibility and we need to categorize only the eligibility denial based on the Kareo plan. If we have the Kareo “Complete” plan, we should have checked the eligibility before submitting the claims. Then it falls in the Internal Denial category.

External Denial: If you don’t have the option to check eligibility within Kareo, then the denial falls in the External Denial category. We can stop these denials by changing to the Kareo “Complete” plan or by checking the providers’ websites and/or educating the front office to check eligibility.

Denials other than eligibility should be checked and sorted into Internal & External categories.

Using this denial summary, we need to categorize the denials as Internal & External denial by the top 20 denial codes. Based on the type of denial, we need to educate our team to reduce these denials. If most of the denials are related to Internal error, we need to provide guidance and education to the team to reduce such errors in the coming months.

For External denials, we need to co-ordinate with the coding team and provider office to stop the denials such as “denied as non-covered service,” “rendering provider is not eligible,” “Pt enrolled in Hospice.” etc. We need to educate the providers to document the medical records more specifically for the service rendered to avoid such denials.

Steps to be followed to reduce denial %:

Generate the Denial summary from year to date and convert into spreadsheet
Sort the denial by descending order by total billed amount
Categorize the External and Internal denials from the Top 20 denials
Identify the Root cause of the Denial
Create a good solution to reduce those denials one by one with the help of coding expert
Educate the team and provider office with the perfect solution for these denials
Next, you will see the denial percentage reducing drastically in the coming months

Denial Category Metric:

If a practice gets less than 5% of denials in the total monthly billed amount, then the practice is in the “Best” category. More than 5% denials should be monitored and need probe review to bring down the denials. The clean claim percentage can be increased by using the report effectively

Best Practice – Less than 5%

Average – Between 5 and 10%

Alarm Bells – Greater than 10%

Conclusion: Managing your denials = Improving your revenue cycle.

Henry Richards
EccoHealth LLC

This is the second month in a row that Henry has won—congratulations! But we’re throwing out the challenge to our many other fine billers, billing services and billing managers: Send your tips in, and you could win the $250 prize!

Please be sure to submit your Medical Billing Tip of the Month to Marketing@Kareo.com by Wednesday, September 26, for inclusion in the next round of judging. We’ll post the top three tips on our Facebook page and on the Kareo blog for your vote! You will win a $250 American Express gift card if your tip is chosen. Good luck!

Kareo August 13th, 2012

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We have our Medical Billing Tip of the Month, and this one won by a landslide! Thank you to everyone who voted on our blog and Facebook. The winner of our Medical Billing Tip of the Month contest this month is…

Using the 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 options 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 report: Use 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 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.

Henry Richards
EccoHealth LLC

This is the second month in a row that the winner came from EccoHealth—they’re a fine organization, but how about our other billing service customers? We want to hear from you, and from those at practices, too; you are all eligible to win!

Please be sure to submit your Medical Billing Tip of the Month to Marketing@Kareo.com by Wednesday, August 22, for inclusion in the next round of judging. We’ll post the top three tips on our Facebook page and on the Kareo blog for your vote! You will win a $250 American Express gift card if your tip is chosen. Good luck!

Kareo July 16th, 2012

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Wow, it was a hard-fought battle this month for Medical Billing Tip of the Month, with more votes than we’ve ever received. It was close, but one tip pulled ahead in the voting. Thank you to everyone who voted on our blog and Facebook. The winner of our Medical Billing Tip of the Month contest this month is…

AR Categorizing Using Batch Number

I make use of the customized reports option in Kareo to pull outstanding claims by category.

The Application:

We use the Batch # field in Kareo to pick a specific category of outstanding claims.

When outstanding claims are analyzed, if the reason is identified to be one of the following:

Insurance f/u required
Already appealed claims
Awaiting EOB
Requires client assistance
Denial

Then the following trick can be used to pull outstanding claims by category.

The Trick:

Below-mentioned category names can be entered in the Batch # field of the analyzed claim [replacing the Charge file name]:

For example,

Insurance f/u required – INS F/U
Already appealed claims – APPEALED CLAIMS
Awaiting EOB – AwEOB
Requires client assistance – CLT ASST
Denial – DNL

Note: The original Charge file name can be copied in the business notes field for future reference of such claims.

The Result:

To pick outstanding claims for a specific category:

Run the Insurance Collection Summary report in Kareo: Reports -> Accounts Receivable -> Insurance Collections Summary

Then click the “Customize” button and enter specific “Category name” on Batch # field & generate the report:

Then Click OK . Outstanding Claims by category will be reflected on the report. Please refer to output screenshot below:

This method has helped me a lot while categorizing outstanding claims and I hope it will be useful for every user.

David Beckett
EccoHealth LLC

Thank you to all who entered; please be sure to submit your Medical Billing Tip of the Month to Marketing@Kareo.com by Wednesday, July 25, for inclusion in the next round of judging. We’ll post the top three tips on our Facebook page and on the Kareo blog for your vote! You will win a $250 American Express gift card if your tip is chosen. Good luck!

Kareo June 4th, 2012

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Though we had a tough choice for the June Medical Billing Tip of the Month this month with 3 great tips, we did have a clear winner. Thank you to everyone who voted on our blog and Facebook. The winner of our Medical Billing Tip of the Month contest this month is…

Organize Patient Accounts for Collections in Kareo

I have created a way to systematically move patient accounts into buckets for our patient collections. I created collection categories and named them with numbers so that the collectors can see the list of collection buckets in order as to how the collection process works. From there I customized each category for statement messages, alerts, and if a statement should be sent or not. Then when we run our collection report, all the accounts are in the right bucket. From this report we call or send letters, then tag the account the next step for next month.

For example:

1 Current

2 Automated payment reminder – this is an auto call using a 3^rd party vendor

3 Delinquency letter

And so on. The method you use for working your patient balances would be how you create your collection categories. See example below:

Cari McCormick, CPMA
VP, Production
Resolutions Billing & Consulting

Thank you to all who entered; please be sure to submit your Medical Billing Tip of the Month to Marketing@Kareo.com by Friday, June 22, for inclusion in the next round of judging. We’ll post the top three tips on our Facebook page and on the Kareo blog for your vote! You will win a $250 American Express gift card if your tip is chosen. Good luck!

Kareo May 7th, 2012

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The results are in! Thank you to everyone who voted on our blog and Facebook for the May Medical Billing Tip of the Month. The winner of our Medical Billing Tip of the Month contest this month is…

Making the Best Use of the Hot Keys in Kareo

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.

Dan Young
Co-Owner, Vice President/Operations
Resolutions Billing & Consulting

Fellow Kareo user Brent Adams of Physicians Advantage Services notes that you can alter some of the hot keys by opening the hotkeys.xml file under the Kareo/Client folder in Program Files.

Thank you to all who entered; please be sure to submit your Medical Billing Tip of the Month to Marketing@Kareo.com by Tuesday, May 22, for inclusion in the next round of judging. We’ll post the top three tips on our Facebook page and on the Kareo blog for your vote! You will win a $250 American Express gift card if your tip is chosen. Good luck!

Kareo April 9th, 2012

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Thank you to everyone who voted on our blog and Facebook for the April Medical Billing Tip of the Month. The winner of our Medical Billing Tip of the Month contest this month is…

ERA Tracking for the Payment Method Code of “Check”

We receive ERAs from the carrier with the payment method code “Check.” We need to track this type of ERA to confirm the check has been sent to the provider’s correct address and to wait until the check was cashed by the provider. Here are the steps we follow to do this:

We create a category in Kareo called “Insurance Pending Check.”
While auto posting payments from Kareo, we select the above category to track this type of ERA. After we have received the EOB from the provider office, we need to confirm with the provider whether this payment has been cashed by the provider; after that we need to change it into the correct category.
Once monthly, we run a report in Kareo called the “Payment Detail” report to see if there are any labeled “Insurance Pending Check” or go to the “Find Payment”(F10) screen and find the category of “Insurance Pending Check.” Then we will contact the carrier or provider about the status of the check.
If the provider did not receive the check or it was sent to the incorrect “pay to” address, we contact the carrier to reissue the new check and void the previous check.
This process insures you will avoid missing checks.

Scott Benjamin
ECCOHealth
Las Vegas, NV

Thank you to all who entered; please be sure to submit your Medical Billing Tip of the Month to Marketing@Kareo.com by Friday, April 20, for inclusion in the next round of judging. We’ll post the top three tips on our Facebook page for your vote! You will win a $250 American Express gift card if your tip is chosen. Good luck!

Kareo Newsletter Is a Medical Practice Management Must Read!

Kareo March 12th, 2013