2015 user conference keeping your eye on the prize$ april 23rd, 2015 presented by: rena lefkowitz...
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2015 User Conference
Keeping Your Eye on the Prize$ April 23rd, 2015
Presented by:
Rena LefkowitzDirector of Training
PM Session
2015 User Conference
Keeping Your Eye on the Prize$ April 24th, 2015
Presented by:
Jen NovakovichPM/EHR Trainer
PM Session
2015 Office Practicum User Conference
Objectives
❏ Tracking financial processes in your Practice
❏ Ensure correct information is obtained❏ Capture all charges❏ Ensure clean claims are processed
2015 Office Practicum User Conference
What players are involved?
2015 Office Practicum User Conference
Appointment
Superbill creation
during visit
Claim creation
Claim tracking
and Collections
Financial Visit Cycle
2015 Office Practicum User Conference
Survey
What gets missed?
Appointment
2015 Office Practicum User Conference
Appointment
Where we can ensure better accuracy:
❏ Correct insurance information❏ Verify and Validate ❏ Rank!!❏ Selecting financial guarantor ❏ Copays/deductibles ❏ Previous balances❏ Self Pay Charges
2015 Office Practicum User Conference
Obtaining Correct Insurance Information
Appointment
❏ Verify at each visit
❏ Validate prior to visit
❏ Always rank!
❏ Select financial guarantor
2015 Office Practicum User Conference
Check In
Appointment
❏ Confirm financial responsibility
❏ Workflow for collecting balances
❏ Review Misc or Billing account notes
❏ Ensure accurate insurance information
2015 Office Practicum User Conference
Survey
What is often
missed?
Superbill creation
during visit
2015 Office Practicum User Conference
Where we can ensure better accuracy:
❏ All work documented in OP
❏ NEW procedure templates
❏ Coding completed at the time of visit
Superbill creation
during visit
2015 Office Practicum User Conference
Documenting all work in OP
Superbill creation
during visit
❏ Manually typed in, this will not create a superbill charge
“If it is not documented it is NOT done.”
❏ Task created, once staff completes task order will process to superbill
2015 Office Practicum User Conference
Procedure Templates
2015 Office Practicum User Conference
Coding Visits
2015 Office Practicum User Conference
Superbill creation
during visitWorkflows?
❏ Diagnostic tests❏ Vaccines❏ Surveys❏ Procedures ie; nebulizer, cerumen
removal
2015 Office Practicum User Conference
Survey
Missing??
Claim creation
2015 Office Practicum User Conference
Where we can ensure better accuracy:
❏ Review superbills/claims❏ Payer specific code requirements ❏ Blocked and Substituted codes❏ Tracking % of each level of visits
to prevent audit
Claim creation
2015 Office Practicum User Conference
Reviewing Superbills/Claims for Accuracy
Claim creation
2015 Office Practicum User Conference
Reviewing Superbills/Claims for Accuracy
Claim creation
2015 Office Practicum User Conference
Payer Specific Codes
Claim creation
❏ Correct Immunization Administration
❏ NDC codes required?
❏ 25 modifier on a well visit visits?
❏ 33 modifier on the preventive codes
2015 Office Practicum User Conference
Blocked and Substituted Codes
Claim creation
2015 Office Practicum User Conference
Tracking % of Each Level of Service
Claim creation
2015 Office Practicum User Conference
Survey
What is overlooked? Claim
tracking and Collections
2015 Office Practicum User Conference
Where we can ensure better accuracy:
❏ How often are payments posted?❏ How often is A/R worked?❏ Is there a workflow for collection
calls❏ Rejection correct in a timely
manor?❏ How often are statment run?
Claim tracking and Collections
2015 Office Practicum User Conference
Payment Posting
Claim tracking and Collections
❏ Save time! Try posting through the Bulk Payments
2015 Office Practicum User Conference
A/R
Claim tracking and Collections
2015 Office Practicum User Conference
Collections
Claim tracking and Collections
2015 Office Practicum User Conference
Rejections
Claim tracking and Collections
2015 Office Practicum User Conference
Statements
Claim tracking and Collections
2015 Office Practicum User Conference
Claims Cycle
Appointment
Superbill charges posted claim
created
Claims transmitted
to clearinghouse
Insurance processes
claims
2015 Office Practicum User Conference
Questions?
2015 Office Practicum User Conference
What three things
stuck with you?
2015 Office Practicum User Conference
2015 Office Practicum User Conference
We want your feedback!