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/

7 Ways to Improve Accounts Receivable and Cash Flow

Could your healthcare facility make use of cash flow sitting stagnant in your Accounts Receivable(AR)?  

Are issues like claim denial, bad debts, needless write-offs, and high staffing turnover hindering your cash flow and efficiency?  

Do you simply want to ensure you are running your medical billing in the most productive and profitable manner? 

Below are 7 ways to make sure your AR is efficient and you improve cash flow! 

1. Create a Routine for Follow-Ups

          Whether you follow up daily, weekly, or once a month- you should have a set routine.  A routine ensures no claim goes without being followed-up and that they are followed-up in the most efficient and correct manner.  Have a system for when you follow-up via email, through online portals, and phone call (phone calls tend to be more successful).  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), how far 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.

2. Have a System with Checks and Balances

          As you are establishing a routine, implementing a system with checks and balances will make certain your claims are proofread, accurate, complete, and ready to be collected.  By putting more than one set of eyes on your claims, you can save valuable time and by not needing to spend labor correcting and resubmitting claims. Yes, you may think the labor of having extra eyes might outweigh the benefit- but, even just a few seconds of review can save hours of having the same person try to figure out what caused the error

3. Increase the Frequency of Collection

          If you are currently submitting and/or only following up monthly on your claims, then you may consider increasing your submissions to bi-monthly, weekly, or bi-weekly.  Increasing your billing cycles means the recipient gets the claim sooner, and in return the claim can be collected sooner.

4. Be Proactive

          This may be a no-brainer and a practice you already adhere to, but before a patient comes in for their appointment or treatment, verify their insurance to make sure they are qualified with your facility.  This can save both you and your patient major headaches when it comes to getting bills paid and collecting AR.  When the patient is aware of their copay and deductibles coming into the appointment, they can be more prepared, and you will be too when it comes time to collect. 

5. Review, Review, Review Write-offs!

          Before writing a claim off, go through all payment options and be sure each have been utilized, plenty of follow-ups have been conducted, and the claim is correct.  Rather than just throwing things at the write-off pile, be thorough and adamant about what gets written off and try hard to collect before resorting to writing off.

6. Run Accounts Receivable Reports

          Examining trends in your collections and accounts receivables will show your team where they need to shift their focus.  REVEX can quickly and efficiently run custom AR reports to help you identify trends and boost your billing team’s efficiency and cash flow.

7.  Outsource!

          Outsourcing your collections on claims, old AR, and AR reports can save you time, money, and increase your cash flow exponentially!  For example, REVEX is an automated medical billing service and software that can be customized to your specific billing needs.  Do you have a high turnover in your billing staff?  Trust REVEX to step in seamlessly with our 20+ experienced billing managers on staff to help with your headaches.  REVEX software helps our teamwork with your team to communicate and delegate your AR collections for optimal collections.  Any billing problems you have, let REVEX help!

Please leave comments, questions, and feel free to expand on our post at the bottom of the page!  We love to hear from other professionals in the industry and to collaborate on how medical billing processes can be improved!  Thanks for reading.

How to Avoid the 5 Most Common Medical Billing Denials

Medical claim denials are a problem for your cash flow. You work hard at reviewing the claims, making sure they are correct and submitted on time. Then, a few days later, the remits come through and 10% of the claims are denying. Likewise, the cost of the re-works is approximately $2.30 per claim. 

If you are like us, you will spend a few hours reviewing these denials and realize how easily they can avoided. You may also realize how much time you could have saved by focusing on the front-end of billing.

Whether you have been in medical billing for 1-year or 30-years, you have run across at least one denial each month. Although denials are a part of the billing cycle, there are ways to prevent claims from denying.

Nevertheless, what are the most common denials? We would like to help you by providing the five most common denials as well as how you can prevent them.

Not only will this help improve cash flow but it will also help you save time in your follow-up process.

By being prepared, you can help your organization stay on top of your claims and avoid the common errors in the future.

The five most common denials throughout medical billing are:

1. Coding Errors
2. Duplicate Claims
3. Expired Timely Filing
4. Incorrect/Missing Information 
5. Non-Covered Charges

Coding Errors
One reason your claims may deny or are denying is that the codes are either missing or inaccurate. For example, Medicare Inpatient Part-B claims require both the onset code and the corresponding occurrence codes for your therapy disciplines. Without these codes, Medicare will deny your claims.

Prevention Tip – Before submitting the claims, review the occurrence codes section to ensure the required codes are present. We recommend having a copy of the therapy report to ensure you use the correct dates and codes. 

Duplicate Claims
A duplicate claim, by definition, is a claim that contains the exact same member identification number, provider number, date of service, type of bill, procedure codes and billed amount of another claim. How does a duplicate claim happen? This happens when you submit or resubmit a claim without the proper adjustment codes or by not reviewing previously submitted claims.

Prevention Tip – Before submitting the claim(s), make sure that an adjustment claim has the corresponding adjustment type of bill and/or references the previous claim. Likewise, you will want to review with the payer if there are any existing claims that will cause a duplicate claim error.

Expired Timely Filing
Perhaps the easiest to avoid but also the easiest to overlook. Most payers have strict guidelines for when you must submit a claim in order for them to process the claim for payment. For example, Medicare’s timely filing limit is one year from the dates of service. 

The process seems simple enough, submit the claims before the time limit and you are set. However, there are some claims which have issues preventing them being processed. Perhaps the member’s coverage was not active yet, you were busy working on another project, or there were larger claims that needed your attention. Whatever the case may be claims can slip through and ultimately become uncollectable due to timely filing.

Prevention Tip – Keep a record of the claims that you need to submit. Likewise, you need to update your report each week to ensure you have submitted all of the claims and that they are on track for processing. 

If you need a quick and easy way to document your notes call or email us to schedule a demo of our AR Note Tracking Software REVEX. This will help prevent your claims from denying for timely filing.

 Incorrect/Missing Information
Another reason claims deny is that the claim is missing or has incorrect information. For example, the claim is missing the patient’s identification number. Once the payer receives the claim, their system will audit the claim information and immediately trigger a denial.

Prevention Tip – Before submitting the claim, make sure you review each demographic field to ensure the resident’s Date of Birth, insurance number, payer ID and/or name is correct. 

Non-Covered Charges
One of the more complex denials is non-covered charges. Non-covered charges require research to ensure you will receive full reimbursement for the services rendered to the patient. This denial occurs when the patient’s plan does not cover the codes on the claim. Likewise, this denial occurs if the claim contains codes that do not match other items on the claim. 

Prevention Tip – If you are dealing with a Medicare Replacement, Medicare Advantage, etc. make sure you call the patient’s plan to confirm if the services are covered. Likewise, make sure as you get ready to bill you review the claim’s revenue codes, modifiers and/or the diagnosis codes.

Summary

Preventing claim denials does not have to be stressful. By focusing on the up front billing (quality checking the claims) and having excellent documentation you can prevent denials on your claims. 

Likewise, as you progress each month you will be able to identify the key fields which caused the denials; and thus, reducing the time it takes you in corrections.

Sources:
https://www.changehealthcare.com/insights/medical-billing-denials-avoidable

https://www.healthcarefinancenews.com/news/top-5-medical-claim-denials 

https://www.m-scribe.com/blog/bid/353875/top-5-medical-claim-denials-in-medical-billing

Jane Hoang

 15d

https://www.meremhealth.com/5-major-reasons-your-claims-are-getting-denied/ 

#1: YOU WAITED TOO LONG

#2: BAD CODING

#3: PATIENT INFORMATION

#4: AUTHORIZATION 

#5: REFERRALS

Tired of having your claims get denied? Hire a medical coding company! Contact MEREM Healthcare Solutions today.

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Jane Hoang

 15d

https://www.changehealthcare.com/insights/medical-billing-denials-avoidable