It’s All Greek to Me! - Learn the Language of Medical-Billing Notes!

According to a Market Research Study hosted by REVEX, around half of medical billers utilize Excel spreadsheets for note taking.  Others use emails, word documents, and their current Patient Relationship Management Systems to maintain notes. ^[3] 

This can present issues when it comes to communication between employees following-up on the same claims; for example, one employee is calling on a claim to follow-up and gets told one thing, while another logs into the online portal and receives different information.  If both employees are taking notes in excel spreadsheets, they may not be receiving real-time updates on the status of the claim and there is a disconnect there.  Also, having two employees following up on the same claim is not efficient when it comes to labor costs. 

What if there was an easier way? A faster way? And automated way? A standardized method to taking notes that saves time and lowers error incidences on your claims... Keep reading if you are tired of your current process and are looking for a way to improve the accuracy and efficiency of your notes/follow-ups!

Let’s review what GREAT notes look like:

1. Great notes are easy to read, clear and concise.  

They should describe the actions you took to reach the conclusion of the claim.  It is ok to use shorthand if the method is standardized amongst all users.  A user should be able to read the last note and know exactly what you did and what needs to be done next.  We recommend a 1-2 sentence summary or action step for each follow-up note.

 

2. Great notes direct you through the follow-ups.

Notes should document actions taken as well as next steps to take.  This allows smooth transitions between billers following up on claims within the same team.

 

3. Great notes set your follow-up schedule/timeline.

Notes should all be tagged with a date/timestamp for accountability and communication between employees.  This will also help save time as you can schedule your follow-ups based on payer and how quickly they process claims/updates.

4. Great notes are accurate, current, and detailed. 

They should include the claim number, the source of the update (called, checked a portal, emailed rep), payment information (Check/EFT number, amount paid, and any other items like copay or deductible).  When it comes to standardizing the language used in notes, it may be helpful to have a template or form for your billers to utilize.  When it comes to being detailed, we highly recommend using call reference numbers when communicating with payors as these can easily be traced or recorded.  Whenever you get a call reference number, you can also help guide customer service reps on subsequent calls so that they can quickly help you on your needs.  You should update the notes at least weekly, so you do not have to spend time in tracking down information as claims pay.

 

5. Great notes are relevant, productive, and include vital information.

Nothing is more frustrating than reading a note and it does not include any new or relevant information.  This goes back to my first and third point of notes needing to be concise and detailed, but I wanted to make the points of relativity and productivity stand out.  Save yourself from frustration and have value-added notes. ^[1]

How can I improve my note taking process?

·       Utilize forms or templates to standardize what needs to be included in each note update.  REVEX offers this feature in our software with a simple form.  With REVEX, our notes can also be automated depending on what custom package you have with us.  Our Biller’s and software automatically update these notes in our software in a concise, productive manner so our teams are always on the same page with live, accurate updates!  See the screenshot below for a sample of the notes form we use:

 

·       Training is key.  Training your staff in a manner that they each utilize the same process is crucial to a cohesive billing team.  This ensures little to no time wasted, higher accuracy in note taking, and great team morale by lowering frustrations.^[2] REVEX also offers services when it comes to training your billing team.  If you need someone to help you develop a billing plan, more efficient note-taking methods, or training your employees- Schedule a meeting with REVEX today!

·       Hold Reviews for your team.  This is a great way to go over their work and help them improve processes and productivity.  Review things like their time spent on certain billing tasks, accuracy in filing claims, note-taking efficiency, and even discuss their needs to improve their work environment.  A review should be both ways to the employee feels heard and can make suggestions for improvement as they are such a strong part of the process.

 

To conclude, note taking is an important part of the medical billing process when you are looking to save time and money.  You can save more time, be more efficient and be more productive by focusing on strategies that reinforce communication and expedite processes. This will help avoid claim errors and miscommunications. REVEX is eager to help you build a custom plan to address your team’s needs. Schedule a meeting with us to get your free quote today!   

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[1] Lundin, Elizabeth. “How to Take Better Notes: The 6 Best Note-Taking Systems.” College Info Geek, 8 Jan. 2020, collegeinfogeek.com/how-to-take-notes-in-college/.

[2] “The Medical Billing Process.” MedicalBillingandCoding.org, MB&CC, 6 Sept. 2019, www.medicalbillingandcoding.org/billing-process/.

[3] REVEX. (2020, June 1). Market Research Study.

Follow-Up, Don’t Fall Out!

Do you have a routine or system in place for following-up on claims?  Have you evaluated your time and efficiency on your follow-up processes?  Have you been looking for a way to save on labor and costs in your Accounts Receivable Department?  Keep reading!!

One of the most time consuming (and frustrating) activities in billing and collections is the follow-ups on claims. Most facilities will submit claims to multiple payers (Medicare, Medicaid, etc.) which means logging in and calling/emailing multiple plans in order to confirm the claim(s) status- AKA a hassle.[2]

In today’s post, we will provide a few tips to help you organize and manage your follow-up process through a routine approach.  A routine ensures no claim goes without being followed-up and that they are followed-up in the most efficient and correct manner.  Having a system for when follow-ups via emails, through online portals, and phone calls also makes the process exponentially more convenient.[1]

  A routine might include which day of the week/month you follow-up, how you initially conduct the follow-up (phone call, portal or email), time between follow-ups, your secondary follow-up method, and so on.  A routine will ensure claims do not get forgotten or swept under the rug.[3]

Step 1: Run/Print the AR report and compile your “Priority List”

Each patient management system (PMS) has its own version of the accounts Receivable (AR) report. This report details each outstanding account.  Most PMSs allow users to run reports by payer (or by resident) which will include a summary page. The summary page will help you identify trends with specific payers.  The full report will allow you to see which residents have the highest balance(s).

Once you have run your AR report, you will need to identify the oldest and largest balances. Another consideration to use is the payer’s timely filing guidelines.[3]

Most billers will either highlight or document these accounts on a separate file or system, which you should maintain each month.[2]

Step 2: Compare your Priority List with your notes

Now that you have your list, you need to review your previous notes.  As you review these notes, you should begin to identify the actions you are going to need to take to complete your next round of follow-ups. 

For example, we often break things down to include whether we will need to call, check a portal, or send an email. This process has helped REVEX billers save hours each day by allowing us to organize similarly related activities and addressing these items based on level of time and difficulty.  

Please schedule a meeting with REVEX if you do not already have a system to document your follow-ups or if you would like help in creating your file.

Step 3: Organize your Follow-Ups

After you have identified the next steps, you need to sort them by the type of follow-up and how much time you will need to complete each update.

In our experience:

Emails and the online portals are the easiest follow-up methods. Phone calls are the hardest (as they take more time).

If your follow-ups require making phone calls then schedule them in the early morning or late afternoon. This is when most customer service lines have fewer calls.

If your follow-ups require checking online or emailing a provider representative, then schedule them around your phone calls.[2]

Step 4: Timeline

85% of billers will follow-up at least weekly on the entirety their accounts.[2]

 We agree that claims need frequent follow-ups for claims to process timely. We also believe that the type of claim will dictate the frequency of these follow-ups!

For example, if a resident has two payers (ex. Medicare as primary and BCBS as secondary) then you will not need to follow-up with the secondary payer until after the primary payer has paid. What about documentation? You should still make notes on the secondary claims; however, a simple note such as “Pending Primary” until the primary pays will help ensure you spend your time wisely on these types of updates. Then, once the primary has paid, you can begin the next steps for the secondary claim.

For your follow-ups, we recommend following-up every 2-3 days on accounts that are approaching their payer’s timely filing guideline. This will help prevent write-offs for timely filing.

For all other accounts, you can schedule them for weekly updates. As payers confirm the claims are set to pay then begin to work on the next round of claims.

REVEX software and services work hard to automate steps 1-4 so your team can focus on step 5! 

Step 5: Execute

Now that you have put in all this hard work in organizing your information, you need to complete the most crucial step; execute your follow-ups!

You have put in all this hard work and you do not want it to go to waste. By having this plan, you can ensure you take each action. Additionally, by having your follow-up routine set you can adapt to your other responsibilities.[1]

Conclusion

The follow-up process does not need to be complicated. By breaking down each account into little (and easy) steps you can build momentum and get through your follow-ups.

If you or your billing team need help with what information you should record in your notes, or the actions you need to take in your follow-ups then please call or email REVEX to schedule a meeting. We would be happy to help you and your team overcome this obstacle and learn to operate as efficiently as possible with a customized plan! 

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Resources:
 
[1] Medical Billing Best Practices. (2016, October 18). Retrieved June 15, 2020, from https://clinicservice.com/best-practices-medical-billing/
[2] REVEX. (2020, June 1). Market Research Study.
[3] Why is A/R Follow-up Crucial in Medical Billing - FWS. (n.d.). Retrieved June 15, 2020, from https://www.flatworldsolutions.com/healthcare/articles/ar-follow-up-importance-medical-billing-process.php

The "Write" and Wrong Way to Write-Off

Is your company missing out on hundreds, maybe even thousands of dollars simply by writing off claims that unknowingly could have been collected on?  

A very conservative write-off figure for some of our customers is 1-2% of monthly charges commonly referred to as the “Bad Debt Allowance.” As an example, if a facility has $200,000 in monthly charges then they can expect at least $2,000 per month or $24,000 per year. 

Through this brief article, let us help you analyze your write-off practices to determine if there is a better way!  Please leave questions/comments/concerns in the comment section below and we would love to help!

Lets first do a quick refresher on which write-offs may be deemed necessary and which may be considered unnecessary.

Necessary or Approved:
-Contractual; the amount over the carrier's allowed amount is written off
-Charity; may be in accordance with a community indigent care effort, a policy adhered to in a faith-led healthcare system, or a financial assistance program.
-Small Balance; outstanding amounts that may not be worth the time or cost of labor to collect on
-Prompt Payment or Self-Pay Discounts; discounted treatment costs for those paying in full at their appointment or who do not have insurance.

Unnecessary:
-Timely Filing; tardy filing in accordance with payers requirements (Medicare requires within 12 months, Medicaid varies, commercial payers vary)
-Uncredentialled Provider; caused by filing a claim for a provider before they are credentialed with the payer*
-Administrative; manager approved due to issues such as: not in-network, practice error, bad service to the patient, etc.
-Bad Debt; simply difficult to collect and you choose to no longer pursue payment. 
-Collection Agency; written off A/R and given to a collection agency on the behalf of the practice (not forgiven, may go to different A/R or collection account).

5 Helpful Write-Off Management Tips

1- Categorize Write-offs (Necessary, Unnecessary, and then into subcategories as needed).  This will help streamline your approaches and make how you tackle these potential write-offs efficiently.

2- Set standards for which write-offs need approval by a manager.  This will help save time for the manager and the biller by not getting routine write-offs signed off on.  Also be sure to have a system of checks & balances to ensure accuracy and that there is not an abuse of power here.

3- Hold a monthly review session for write-offs where trends, issues, accuracy, and areas of improvement are reviewed.  You need to make adjustments to your system according to fee and contract adjustments.  This also shows the staff they are being held accountable for their work.

4- Finally, try not to write-off more than 5% of expected claim collections (utilized the formula gross charges minus necessary and approved write-offs).

5- Consider utilizing a third-party medical billing company to review claims and report back which should be written off, which can still be collected, and to see if old AR is collectable as well.  This is one of the custom medical billing services REVEX offers; if you are interested, please reach out to info@mcaskilled.com for a free consultation or drop a comment below!

Please leave questions/comments/concerns in the comment section below and we would love to help!



https://managemypractice.com/the-right-way-to-do-write-offs/