Physiatry Billing – No Silver Bullet By Bruno M. Stillo, CPA, MBA
What is the magical way to improve your billing and collection function? Unfortunately, there is none – no hidden secret, no “silver bullet.” However, adherence to several fundamentals will work just as well.
How to maximize upfront billings:
Capture all performed services! For outpatient services, medical offices usually employ a pre-printed superbill which can easily be misplaced. Suggestion: Match each patient on the appointment schedule to a corresponding superbill.
For each patient admitted to a rehab facility, there is usually an initial charge, regular follayvups, and ultimately a discharge code. Suggestion: Any gap in inpatient billings should be brought to the provider’s attention.
Simple data entry errors can cost the practice thousands of dollars. Suggestion: Have a second person, not the data entry person, check all data entry.
How to maximize collections:
Followup, follayvup, follayvup!
Pursue vigorously by telephone or in ‘writing all insurance denials, and non-responses. Many billing personnel find calling insurance companies to be stressful and time-consuming, when in reality they are usually helpful in resolving problem claims. TELEPHONE FOLLOWUP IS A KEY COMPONENT OF THE COLLECTION FUNCTION. Suggestions: When calling the insurance carrier to reprocess the denied claim, get a reference number. When calling about a claim with no response, try to fax the claim.
If a telephone call cannot resolve the denied claim, then a written appeal should be sent. Suggestion: Design a preprinted Appeal Form which can be filled in with the necessary information.
Sometimes, the patient’s insurance information is incorrect. Although it is very easy to simply send a bill to the patient, it is not the most effective way. You have a better chance of collecting money from the insurance company than from the patient. Suggestion: Research thoroughly the insurance problem by calling the patient, and by calling the insurance company. Billing the patient should be the last resort.
As has been demonstrated, billings can be maximized by capturing all services performed.
Bruno Stillo,CPA is the owner of Physiatry Billing Specialists, 800-835-4482, [email protected]